TY 2019 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
MEDICAL SOLUTIONS LLC 1010 N 102ND ST OMAHA,NE68114	STAFFING SERVICES	9,700,941
ANESTHESIA SRV OF SAN JOAQUIN 10 C0MMERCE DR NEW ROCHELLE,NY10801	MEDICAL/PHYSICIAN SERVICES	6,234,843
INPATIENT SPECIALISTS OF CALIF PO BOX 742936 LOS ANGELES,CA900742936	MEDICAL/PHYSICIAN SERVICES	5,831,212
SAN JOAQUIN CRITICAL CARE 1801 E MARCH LANE STE C300 STOCKTON,CA95210	MEDICAL/PHYSICIAN SERVICES	2,127,350
BLOODSOURCE 10536 PETER A MCCUEN BLVD MATHER,CA956554128	PRODUCT/TESTING SERVICES	2,090,775
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 73

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization PORT CITY OPERATING COMPANY LLC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization PORT CITY OPERATING COMPANY LLC		Employer identification number 46-5322209

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization PORT CITY OPERATING COMPANY LLC			Employer identification number 46-5322209
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2019

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

53,875

Total. Add lines 1c through 1i ....................................................................................................

53,875

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	LOBBYING EXPENDITURES PAID DIRECTLY BY THE FILING ORGANIZATION FOR ANNUAL MEMBERSHIP DUES: AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES: $ 7 AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS: $ 42 CALIFORNA SOCIETY OF HEALTH SYSTEMS PHARMACISTS: $ 37 GREATER STOCKTON CHAMBER OF COMMERCE: $ 83 CALCPA: $ 21 INTERNATIONAL FACILITY MANAGEMENT ASSOCIATION: $ 10 AMERICAN ACADEMY OF EMERGENCY MEDICINE: $ 26 AMERICAN ACADEMY OF FAMILY PHYSICIANS: $ 157 AMERICAN COLLEGE OF EMERGENCY PHYSICIANS: $ 1,826 AMERICAN COLLEGE OF PHYSICIANS: $ 55 AMERICAN PHYSICAL THERAPY ASSOCIATION: $ 64 LOBBYING EXPENDITURES PAID BY THE PARENT ORGANIZATION FOR ANNUAL MEMBERSHIP DUES WHERE EXPENSES ARE ALLOCATED TO THE HOSPITAL: 340 B HEALTH: $ 200 CATHOLIC HEALTH ASSOCIATION: $ 3,623 HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA: $ 30,031 AMERICAN HOSPITAL ASSOCIATION: $ 16,118 ALLIANCE OF CATHOLIC HEALTH: $ 1,411 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES: $ 100 ELEVATING HOME: $ 60 TOTAL EXPENDITURES PAID TO ORGANIZATIONS: $ 53,875

Return Reference

Explanation

PART II-B, LINE 1:

LOBBYING EXPENDITURES PAID DIRECTLY BY THE FILING ORGANIZATION FOR ANNUAL MEMBERSHIP DUES: AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES: $ 7 AMERICAN SOCIETY OF HEALTH SYSTEM PHARMACISTS: $ 42 CALIFORNA SOCIETY OF HEALTH SYSTEMS PHARMACISTS: $ 37 GREATER STOCKTON CHAMBER OF COMMERCE: $ 83 CALCPA: $ 21 INTERNATIONAL FACILITY MANAGEMENT ASSOCIATION: $ 10 AMERICAN ACADEMY OF EMERGENCY MEDICINE: $ 26 AMERICAN ACADEMY OF FAMILY PHYSICIANS: $ 157 AMERICAN COLLEGE OF EMERGENCY PHYSICIANS: $ 1,826 AMERICAN COLLEGE OF PHYSICIANS: $ 55 AMERICAN PHYSICAL THERAPY ASSOCIATION: $ 64 LOBBYING EXPENDITURES PAID BY THE PARENT ORGANIZATION FOR ANNUAL MEMBERSHIP DUES WHERE EXPENSES ARE ALLOCATED TO THE HOSPITAL: 340 B HEALTH: $ 200 CATHOLIC HEALTH ASSOCIATION: $ 3,623 HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA: $ 30,031 AMERICAN HOSPITAL ASSOCIATION: $ 16,118 ALLIANCE OF CATHOLIC HEALTH: $ 1,411 CALIFORNIA ASSOCIATION FOR HEALTH SERVICES: $ 100 ELEVATING HOME: $ 60 TOTAL EXPENDITURES PAID TO ORGANIZATIONS: $ 53,875

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	13,660,000		13,660,000
b	Buildings ....	197,877,542	11,548,668	186,328,874
c	Leasehold improvements	267,900	98,210	169,690
d	Equipment ....	51,236,081	16,199,647	35,036,434
e	Other .....	9,643,894	104,621	9,539,273
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				244,734,271

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) OTHER SECURITIES	66,526,969	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	66,526,969

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	17,326,156
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART X, LINE 2:	ST. JOSEPH'S MEDICAL CENTER OF STOCKTON AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER REVIEW ITS TAX QUARTERLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 25000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 50000.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		6,278	3,603,838	157,491	3,446,347	0.540 %
b	Medicaid (from Worksheet 3, column a) . . . . .		61,610	204,434,670	196,634,570	7,800,100	1.210 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		67,888	208,038,508	196,792,061	11,246,447	1.750 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	37	13,711	4,802,802	509,310	4,293,492	0.670 %
f	Health professions education (from Worksheet 5) . . .	10	872	11,633,976	2,127,488	9,506,488	1.480 %
g	Subsidized health services (from Worksheet 6) . . . .	2	223	11,535	0	11,535	0 %
h	Research (from Worksheet 7) .	1	0	578,997	73,764	505,233	0.080 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	11	4,577	1,017,209	1,460,136	0	0 %
j	Total. Other Benefits . .	61	19,383	18,044,519	4,170,698	14,316,748	2.230 %
k	Total. Add lines 7d and 7j .	61	87,271	226,083,027	200,962,759	25,563,195	3.980 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

4,443,930

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

146,530,211

Enter Medicare allowable costs of care relating to payments on line 5.....

147,503,311

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-973,100

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 ST JOSEPH'S SURGERY CENTER LP	SURGERY CENTER	70.180 %	8.200 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)						Facility reporting group
1	ST JOSEPHS MEDICAL CENTER OF STOCKTON 1800 N CALIFORNIA ST STOCKTON,CA95204 WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORN 030000284	X	X	X	X	A
2	ST JOSEPHS BEHAVIORAL HEALTH CENTER 2510 N CALIFORNIA ST STOCKTON,CA95204 WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORN 030000367	X				A

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	FACILITY GROUP A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, PAGE 8

Other website (list url): WWW.HEALTHIERSANJOAQUIN.ORG

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, PAGE 8

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY GROUP A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 500.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, PAGE 8

The FAP application form was widely available on a website (list url):

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY GROUP A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	FACILITY GROUP A
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: ST JOSEPHS MEDICAL CENTER OF STOCKTON, - FACILITY 2: ST JOSEPHS BEHAVIORAL HEALTH CENTER
FACILITY GROUP A PART V, SECTION B, LINE 5:	FOR THE 2019 CHNA, COMMUNITY INPUT WAS OBTAINED FROM A BROAD RANGE OF COMMUNITY MEMBERS USING KEY INFORMANT INTERVIEWS, FOCUS GROUPS AND SURVEYS. INDIVIDUALS WITH KNOWLEDGE, INFORMATION AND EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY WERE CONSULTED. THESE INDIVIDUALS INCLUDED REPRESENTATIVES FROM LOCAL GOVERNMENTAL AND PUBLIC HEALTH AGENCIES AS WELL AS LEADERS, REPRESENTATIVES, OR MEMBERS OF UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. THE HOSPITAL CONDUCTED KEY INFORMANT INTERVIEWS WITH ELEVEN INDIVIDUALS REPRESENTING DIVERSE SECTORS INCLUDING: PUBLIC HEALTH, HEALTH CARE, COMMUNITY-BASED ORGANIZATIONS, SOCIAL SERVICES, EDUCATION AND GOVERNMENT. ORGANIZATIONS REPRESENTED IN INTERVIEWS INCLUDED: SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES, COMMUNITY MEDICAL CENTERS, SAN JOAQUIN GENERAL HOSPITAL, SAN JOAQUIN COUNTY OFFICE OF EDUCATION, SAN JOAQUIN COUNTY HUMAN SERVICES AGENCY, SAN JOAQUIN COUNTY BEHAVIORAL HEALTH SERVICES, FAMILY RESOURCE AND REFERRAL CENTER, FIRST 5 SAN JOAQUIN COUNTY, ST MARY'S DINING ROOM, SAN JOAQUIN PRIDE CENTER, AND ASIAN PACIFIC SELF DEVELOPMENT AND RESIDENTIAL ASSOCIATION. THIRTY-ONE COMMUNITY RESIDENT FOCUS GROUPS WERE CONDUCTED IN GEOGRAPHIC AREAS WITHIN SAN JOAQUIN COUNTY, INCLUDING STOCKTON, LODI, TRACY AND MANTECA. NINETEEN GROUPS WERE CONDUCTED IN ENGLISH, TEN WERE CONDUCTED IN SPANISH, ONE WAS CONDUCTED IN TAGALOG AND ONE WAS CONDUCTED IN CAMBODIAN. PARTICIPANTS WERE TEENS, ADULTS, AND OLDER ADULTS, WHO REPRESENTED UNDERSERVED, LOW-INCOME, AND VARIED ETHNIC COMMUNITIES.
FACILITY GROUP A PART V, SECTION B, LINE 6A:	MEMBERS OF THE HEALTHIER SAN JOAQUIN COLLABORATIVE, INCLUDING: ADVENTIST HEALTH LODI MEMORIAL, DAMERON HOSPITAL, KAISER PERMANENTE HOSPITAL IN MANTECA, SUTTER TRACY COMMUNITY HOSPITAL.
FACILITY GROUP A PART V, SECTION B, LINE 6B:	MEMBERS OF THE HEALTHIER SAN JOAQUIN COLLABORATIVE, INCLUDING: COMMUNITY MEDICAL CENTERS, FIRST 5 SAN JOAQUIN, HEALTH NET, HEALTH PLAN OF SAN JOAQUIN, SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES.
FACILITY GROUP A PART V, SECTION B, LINE 11:	ST. JOSEPH'S MEDICAL CENTER OF STOCKTONTHE SIGNIFICANT COMMUNITY HEALTH NEEDS THE HOSPITAL IS HELPING TO ADDRESS WERE IDENTIFIED IN THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. NEEDS BEING ADDRESSED BY STRATEGIES AND PROGRAMS ARE: MENTAL HEALTH, ECONOMIC SECURITY, OBESITY/HEALTHY EATING ACTIVE LIVING/DIABETES, AND VIOLENCE/INJURY PREVENTION, ACCESS TO CARE, SUBSTANCE ABUSE/TOBACCO, ORAL HEALTH. MENTAL HEALTH: FRIENDS OF SENIORS & FRIENDS OF SENIORS LINKS PROJECT, COMMUNITY HEALTH SOCIAL WORKER, FAITH COMMUNITY HEALTH PARTNERSHIP, COMMUNITY GRANTS AWARDED FOR MENTAL HEALTH PROJECTS. ECONOMIC SECURITY: CONNECTED COMMUNITY NETWORK, SAN JOAQUIN COUNTY CONTINUUM OF CARE, SAN JOAQUIN COUNTY WHOLE PERSON CARE, GOSPEL CENTER RESCUE MISSION RECUPERATIVE CARE, COMMUNITY GRANTS. OBESITY/HEALTHY EATING ACTIVE LIVING/DIABETES: DIABETES EDUCATION AND EMPOWERMENT PROGRAM, DIABETES NAVIGATOR, CERTIFIED DIABETES EDUCATOR CONSULTATIONS,SWEET JOURNEY 101, SUGAR FIX SUPPORT GROUP, MATTER OF BALANCE, SAN JOAQUIN COMMUNITY HEALTH IMPROVEMENT PLAN. VIOLENCE/INJURY PREVENTION: HUMAN TRAFFICKING EDUCATION AND OUTREACH, COMMUNITY HEALTH SOCIAL WORKER, SAN JOAQUIN COMMUNITY HEALTH IMPROVEMENT PLAN. ACCESS TO CARE: SAN JOAQUIN COUNTY WHOLE PERSON CARE, GRADUATE MEDICAL EDUCATION TO TRAIN NEW PHYSICIANS, FINANCIAL SUPPORT OF ST. MARY'S DINING ROOM'S HEALTH AND DENTAL CLINICS, PATIENT FINANCIAL ASSISTANCE PROGRAM, COMMUNITY GRANTS. SUBSTANCE ABUSE/TOBACCO: CALIFORNIA BRIDGE PROGRAM OPIOID GRANT. ORAL HEALTH: FINANCIAL SUPPORT FOR ST. MARY'S DINING ROOM DENTAL CLINIC. THE HOSPITAL WILL NOT ADDRESS THE NEED OF ASTHMA, SO THAT RESOURCES CAN BE DIRECTED TOWARDS HIGHER PRIORITY NEEDS. IN ADDITION, THE UNIVERSITY OF THE PACIFIC'S SCHOOL OF PHARMACY OFFERS PERSONALIZED EDUCATION FOR BOTH PEDIATRIC AND ADULT PATIENTS VIA THEIR ASTHMA CLINIC WHICH IS OPEN TO ALL MEMBERS OF THE SAN JOAQUIN COMMUNITY. THE HOSPITAL WILL NOT ADDRESS "CLIMATE AND HEALTH" BECAUSE THE TOPIC IS NOT THE HOSPITAL'S AREA OF EXPERTISE.ST. JOSEPH'S BEHAVIORAL HEALTH CENTERTHE MENTAL HEALTH SIGNIFICANT COMMUNITY HEALTH NEED THE HOSPITAL IS HELPING TO ADDRESS WAS IDENTIFIED IN THE HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITAL INTENDS TO TAKE SEVERAL ACTIONS AND TO DEDICATE RESOURCES TO THESE NEEDS, INCLUDING: BEHAVIORAL EVALUATION SERVICES WHICH PROVIDE FREE EVALUATION TO INDIVIDUALS WITH BEHAVIORAL HEALTH CONCERNS; COMMUNITY SUPPORT GROUPS AND AFTERCARE SERVICES, WHICH PROVIDE FREE SUPPORT PROGRAM TO INDIVIDUALS LIVING WITH LIFE-AFFECTING SUBSTANCE OR CONTINUING BEHAVIOR HEALTH ISSUES; FREE TRANSPORTATION FOR QUALIFIED CLIENTS THAT OTHERWISE WOULD NOT BE ABLE TO ATTEND OUR OUTPATIENT SERVICES GROUPS. OTHER SIGNIFICANT NEEDS IDENTIFIED IN THE HOSPITAL'S COLLABORATIVE CHNA INCLUDE: ECONOMIC SECURITY, OBESITY/HEALTHY EATING ACTIVE LIVING/DIABETES, AND VIOLENCE/INJURY PREVENTION, ACCESS TO CARE, SUBSTANCE ABUSE/TOBACCO, ORAL HEALTH, ASTHMA, AND CLIMATE AND HEALTH. AS A HOSPITAL EXCLUSIVELY DELIVERING BEHAVIORAL HEALTH SERVICES, NEEDS IDENTIFIED IN THE BROADER CHNA BEYOND MENTAL HEALTH ARE NOT ONES THAT THE HOSPITAL IS ABLE TO ADDRESS. OTHER HOSPITALS AND COMMUNITY SERVICE ORGANIZATIONS IN THE REGION ARE ADDRESSING THESE NEEDS.
FACILITY GROUP A PART V, SECTION B, LINE 16J:	ADDITIONAL MEASURES TAKEN TO PUBLICIZE THE HOSPITAL FACILITIES' FINANCIAL ASSISTANCE POLICY INCLUDE THE PROVISION OF BROCHURES EXPLAINING AVAILABLE GOVERNMENT SPONSORED PROGRAMS AND THE FINANCIAL ASSISTANCE POLICY, AND SHARING THE POLICY WITH MEMBERS OF THE HEALTHIER COMMUNITY COALITION THAT INCLUDES ALL AREA HOSPITALS AND CATHOLIC CHARITIES, COMMUNITY MEDICAL CENTERS, COMMUNITY PARTNERSHIP FOR FAMILIES OF SAN JOAQUIN, EL CONCILIO, FATHERS AND FAMILIES OF SAN JOAQUIN, GOSPEL CENTER RESCUE MISSION, HEALTH NET, HEALTH PLAN OF SAN JOAQUIN, SAN JOAQUIN COUNTY HEALTH CARE SERVICES, STOCKTON UNIFIED SCHOOL DISTRICT, UNIVERSITY OF THE PACIFIC, YMCA.
PART V, SECTION B, LINE 7A	ALL DIGNITY HEALTH HOSPITAL FACILITY COMMUNITY HEALTH NEEDS ASSESSMENT REPORTS CAN BE ACCESSED AT WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-PROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSCHNA REPORT WEB SITE LOCATIONS FOR EACH HOSPITAL FACILITY ARE PROVIDED BELOW.ST. JOSEPH'S MEDICAL CENTER OF STOCKTONWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/ABOUT-US/COMMUNITY-PROGRAMS/COMMUNITY-HEALTH-NEEDS-ASSESMENTST. JOSEPH'S BEHAVIORAL HEALTH CENTERWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/ABOUT-US/COMMUNITY-HEALTH
PART V, SECTION B, LINE 10A	THE ORGANIZATION'S IMPLEMENTATION STRATEGY DOCUMENTS CAN BE ACCESSED ATWWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-PROGRAMS-AND-REPORTS/COMMUNITY-HEALTH-NEEDS-ASSESSMENTSIMPLEMENTATION STRATEGY DOCUMENTS ARE ALSO ON EACH HOSPITAL FACILITY'S WEB SITE, AT THE SAME LOCATIONS AS THEIR CHNA REPORTS LISTED IN PART V, SECTION B, LINE 7A ABOVE.
PART V, SECTION B, LINE 16A, 16B AND 16C	ST JOSEPH'S MEDICAL CENTER OF STOCKTONWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHS-STOCKTON/PATIENTS-AND-VISITORS/FOR-PATIENTS/BILLING-INFORMATIONST JOSEPH'S BEHAVIORAL HEALTH CENTERWWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/PATIENTS-AND-VISITORS/PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE

Schedule H (Form 990) 2019

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?1
Name and address		Type of Facility (describe)
1	1 - ST JOSEPH'S SURGERY CENTER LP 1800 N CALIFORNIA STREET SUITE 1 STOCKTON,CA95204	SURGERY CENTER
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5
6
7
8
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10

Schedule H (Form 990) 2019

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7:	PORT CITY OPERATING COMPANY, LLC, DBA ST. JOSEPH'S MEDICAL CENTER OF STOCKTON (SJMC) AND ST. JOSEPH'S BEHAVORIAL HEALTH CENTER (BHC) FOLLOWS THE METHOD USED BY DIGNITY HEALTH. FOR PURPOSES OF CALCULATING THE AMOUNTS PROVIDED IN THE TABLE, SJMC AND BHC USES A COST ACCOUNTING SYSTEM THAT COMBINES RELATIVE VALUE UNITS (RVU) AND COST TO CHARGE RATIOS (CCR) TO ALLOCATE COSTS TO THE PATIENT LEVEL. THE COST ACCOUNTING SYSTEM ALGORITHM ALLOCATES TOTAL OPERATING EXPENSES TO THE PROCEDURE CHARGE CODE LEVEL BASED UPON AN RVU FOR PROCEDURES THAT HAVE BEEN STUDIED AND ASSIGNED AN RVU, OR BASED UPON A CCR FOR UNSTUDIED PROCEDURES THAT DO NOT HAVE AN RVU ASSIGNED. WHEN A CCR IS USED, THE SYSTEM CALCULATES THAT CCR ON A DEPARTMENTAL SPECIFIC BASIS AT EACH INDIVIDUAL FACILITY WHERE THE SERVICES WERE PROVIDED. THE CALCULATION IS SIMILAR TO THE WORKSHEET 2 OF SCHEDULE H, RATIO OF PATIENT CARE COST TO CHARGES, EXCEPT IT IS CALCULATED ON A DEPARTMENTAL SPECIFIC BASIS, NOT IN THE AGGREGATE. THE ALLOCATED PROCEDURE CHARGE CODE LEVEL COSTS ARE THEN ROLLED UP TO THE PATIENT LEVEL BASED UPON THE BILLED PROCEDURE CHARGE CODES ASSOCIATED WITH THOSE SERVICES PROVIDED TO EACH SPECIFIC PATIENT. THIS IS DONE FOR ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY DEPARTMENT, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED AND SELF-PAY.THE COST ACCOUNTING SYSTEM IS UTILIZED TO DETERMINE THE UNREIMBURSED COST OF MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST OF CHARITY CARE IS CALCULATED BY APPLYING THE CCR DERIVED FROM THE COST ACCOUNTING SYSTEM ON A PER FACILITY BASIS, TO THE CHARGES INCURRED ON PATIENTS THAT QUALIFY FOR CHARITY CARE AT THE RESPECTIVE FACILITY. THE ACTUAL COST IS REPORTED FOR OTHER COMMUNITY BENEFIT ACTIVITIES SUCH AS COMMUNITY HEALTH IMPROVEMENT SERVICES, COMMUNITY BENEFIT OPERATIONS AND CASH AND IN-KIND DONATIONS.PART I, LINE 7, COLUMN (F)BEGINNING IN 2009, THE STATE OF CALIFORNIA ESTABLISHED PROVIDER FEE PROGRAMS. THESE PROGRAMS ARE FUNDED BY QUALITY ASSURANCE FEES PAID BY PARTICIPATING HOSPITALS AND MATCHING FEDERAL FUNDS. PORT CITY'S HOSPITAL FACILTIES RECOGNIZED QUALITY ASSURANCE FEES DURING THE YEAR OF $55.9 MILLION WHICH ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE RELATED TO UNREIMBURSED MEDICAID (PART I, LINE 7B, COLUMN C), AND RECOGNIZED FEE-FOR-SERVICE SUPPLEMENTAL PAYMENTS OF $32.2 MILLION DURING THE YEAR REFLECTED UNDER THE MEDICAID PROGRAM AS DIRECT OFFSETTING REVENUE (PART I, LINE 7B, COLUMN D). THIS NET REDUCTION IN THE COST OF THE MEDICAID PROGRAM IS DRIVING THE DECREASE IN THE OVERALL COST OF COMMUNITY BENEFIT EXPENSE AS A PERCENT OF TOTAL EXPENSES WHEN COMPARED TO PRIOR YEARS.
PART I, LINE 7G:	INCLUDED IN SUBSIDIZED HEALTH SERVICES IS $9,968 OF SUBSIDIZED HEALTH SERVICES ASSOCIATED WITH PHYSICIAN CLINICS AS THESE SERVICES ARE PROVIDED TO THE COMMUNITIES AT A FINANCIAL LOSS. IF DIGNITY HEALTH DID NOT PROVIDE THESE SERVICES, THEY WOULD EITHER BE UNAVAILABLE OR INSUFFICIENTLY AVAILABLE IN THE COMMUNITY, OR THE SERVICE WOULD BECOME THE RESPONSIBILITY OF THE GOVERNMENT OR ANOTHER TAX-EXEMPT ORGANIZATION.PART I, LINE 7I:INCLUDED IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT IS $443 THOUSAND IN GRANTS TO A FUND ESTABLISHED BY THE CALIFORNIA HEALTH FOUNDATION AND TRUST ("CHFT") FOR SEVERAL PURPOSES, INCLUDING AGGREGATING AND DISTRIBUTING FINANCIAL RESOURCES TO SUPPORT CHARITABLE ACTIVITIES AT VARIOUS HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA, CONSISTENT WITH CHFT'S MISSION OF SUPPORTING HEALTH CARE, ACCESS TO HEALTH CARE, RESEARCH AND EDUCATION.
PART II, COMMUNITY BUILDING ACTIVITIES:	NO COMMUNITY BUILDING ACTIVITIES WERE REPORTED DURING THE TAX YEAR.
PART III, LINE 2:	THE AMOUNT OF THE ORGANIZATION'S BAD DEBT AT COST IS DETERMINED BY APPLYING THE CCR (SEE ABOVE) TO PATIENT CHARGES THAT ARE DEEMED TO BE UNCOLLECTIBLE. THIS AMOUNT REPRESENTS THE COST OF SERVICES PROVIDED TO PATIENTS WHO ARE UNABLE OR REFUSE TO PAY THEIR BILLS AND DO NOT QUALIFY FOR FREE OR DISCOUNTED CARE, GOVERNMENT SPONSORED PROGRAMS OR OTHER FINANCIAL ASSISTANCE, AND ARE OTHERWISE UNINSURED. ANY PORTION OF A PATIENT BILL REMAINING AFTER APPLYING FINANCIAL, UNINSURED OR OTHER DISCOUNTS OR PAYMENTS RECEIVED ON THE ACCOUNT THAT ARE ULTIMATELY DETERMINED TO BE UNCOLLECTIBLE ARE WRITTEN OFF TO BAD DEBT.PORT CITY PROVIDES FREE OR DISCOUNTED CARE TO UNINSURED OR UNDER-INSURED INDIVIDUALS THAT FALL INTO THREE CATEGORIES; UNDER 250%, 251%-350% OR 351%-500% OF THE FEDERAL POVERTY LEVEL. PORT CITY ALSO PROVIDES PATIENTS OPTIONS FOR PROMPT PAY DISCOUNTS AND INTEREST-FREE EXTENDED PAYMENT PLANS FOR PATIENTS WHO HAVE DEMONSTRATED GOOD FAITH AND ARE COOPERATING IN RESOLVING THEIR HOSPITAL BILLS. ALL ACCOUNTS FOR ELIGIBLE UNINSURED PATIENTS RECEIVE AN AUTOMATIC UNINSURED DISCOUNT OF 30%. THE EXPECTED PATIENT PAYMENT AMOUNT ON THE PATIENT'S BILL REFLECTS THIS DISCOUNT. DISCOUNTS ARE ACCOUNTED FOR AS DEDUCTIONS FROM REVENUE, NOT AS BAD DEBT EXPENSE.
PART III, LINE 3:	PORT CITY MAKES EVERY EFFORT IN DETERMINING IF A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE UPON ADMISSION. PORT CITY FOLLOWS DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY. DIGNITY HEALTH'S FINANCIAL ASSISTANCE POLICY IS COMMUNICATED TO PATIENTS UPON ADMISSION AND IS AVAILABLE IN THE LANGUAGES PRIMARILY SPOKEN IN THE COMMUNITY. IT IS ALSO POSTED IN VARIOUS COMMON AREAS OF THE HOSPITAL, SUCH AS EMERGENCY ROOMS, ADMITTING AND REGISTRATION DEPARTMENTS, HOSPITAL BUSINESS OFFICES LOCATED ON FACILITY CAMPUSES, AND OTHER PUBLIC PLACES, AND IS PROVIDED UPON BILLING IF ELIGIBILITY IS NOT PREVIOUSLY DETERMINED. ELIGIBILITY IS REEVALUATED AS NEEDED AND AMOUNTS ARE CLASSIFIED AS CHARITY AS SOON AS ELIGIBILITY IS KNOWN. DIGNITY HEALTH ALSO UTILIZES A PAYMENT ASSISTANCE RANK ORDERING (PARO) SCORING SYSTEM TO ASSIST IN DETERMINING IF AN UNINSURED PATIENT MAY QUALIFY FOR PAYMENT ASSISTANCE EVEN THOUGH THEY HAVE NOT APPLIED FOR IT. PARO IS A METHODOLOGY THAT APPLIES CONSISTENT SCREENING AND APPLICATION STANDARDS TO ALL UNINSURED PATIENTS UTILIZING HISTORICAL DATA TO DEVELOP A PREDICTIVE MODEL FOR HEALTHCARE PAYMENT ASSISTANCE. IN ITS DEVELOPMENT, SPECIAL ATTENTION WAS PAID TO THOSE SOCIOECONOMIC FACTORS THAT MIGHT ADVERSELY AFFECT THOSE PATIENTS DESERVING THE MOST ATTENTION. OTHER CRITERIA ARE ALSO UTILIZED TO ENSURE THAT NO SERVICES THAT HAVE QUALIFIED AS FINANCIAL ASSISTANCE WERE REPORTED AS BAD DEBT. AS SUCH, DIGNITY HEALTH DOES NOT BELIEVE THAT ANY AMOUNTS INCLUDED IN PART III, LINE 2, ARE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S PAYMENT ASSISTANCE POLICY, AND THEREFORE, NO PORTION OF BAD DEBT EXPENSE IS INCLUDED AS COMMUNITY BENEFIT EXPENSE.
PART III, LINE 4:	THE FOLLOWING IS AN EXCERPT FROM COMMONSPIRIT HEALTH'S CONSOLIDATED ANNUAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2020, RELATED TO ACCOUNTS RECEIVABLE AND NET PATIENT REVENUE:PATIENT SERVICE REVENUE IS REPORTED AT THE AMOUNTS THAT REFLECT THE CONSIDERATION COMMONSPIRIT EXPECTS TO BE PAID IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE AMOUNTS ARE DUE FROM PATIENTS, THIRD-PARTY PAYORS (INCLUDING HEALTH INSURERS AND GOVERNMENT PROGRAMS), AND OTHERS, AND INCLUDE CONSIDERATION FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO SETTLEMENT OF AUDITS AND REVIEWS. GENERALLY, PERFORMANCE OBLIGATIONS FOR PATIENTS RECEIVING INPATIENT ACUTE CARE SERVICES AND OUTPATIENT SERVICES ARE RECOGNIZED OVER TIME AS SERVICES ARE PROVIDED. NET PATIENT REVENUE IS PRIMARILY COMPRISED OF HOSPITAL AND PHYSICIAN SERVICES.PORT CITY MANAGES ITS COLLECTION RISK BY REGULARLY REVIEWING ITS ACCOUNTS AND CONTRACTS AND BY PROVIDING APPROPRIATE ALLOWANCES. RESERVES FOR CHARITY AND UNCOLLECTIBLE AMOUNTS HAVE BEEN ESTABLISHED AND ARE NETTED AGAINST PATIENT ACCOUNTS RECEIVABLE IN THE CONSOLIDATED BALANCE SHEET.
PART III, LINE 8:	PORT CITY PREPARES MEDICARE COST REPORTS IN A MANNER THAT COMPLIES WITH PROVIDER REIMBURSEMENT MANUAL (PRM) 15-1, 2150FF AND PRM 15-2, 1000FF. AS SUCH, THE FOLLOWING LANGUAGE PER THE PRM 15-1 DESCRIBES THE COMPUTATION OF COSTS PER THE MEDICARE COST REPORT:TOTAL ALLOWABLE COSTS OF A PROVIDER ARE APPORTIONED BETWEEN PROGRAM BENEFICIARIES AND OTHER PATIENTS SO THAT THE SHARE BORNE BY THE PROGRAM IS BASED UPON ACTUAL SERVICES RECEIVED BY PROGRAM BENEFICIARIES. THE RATIO OF COVERED BENEFICIARY CHARGES TO TOTAL PATIENT CHARGES FOR THE SERVICES OF EACH ANCILLARY DEPARTMENT IS APPLIED TO THE COST OF THE DEPARTMENT. ADDED TO THIS AMOUNT IS THE COST OF ROUTINE SERVICES FOR PROGRAM BENEFICIARIES, DETERMINED ON THE BASIS OF A SEPARATE AVERAGE COST PER DIEM FOR ALL PATIENTS FOR GENERAL ROUTINE PATIENT CARE AREAS. ANOTHER FACTOR TO BE CONSIDERED IS A SEPARATE AVERAGE COST PER DIEM FOR EACH INTENSIVE CARE UNIT, CORONARY CARE UNIT, AND OTHER SPECIAL CARE INPATIENT HOSPITAL UNITS.COMMONSPIRIT HEALTH, INCLUDING DIGNITY HEALTH AND ITS SUBORDINATES, WHICH INCLUDES PORT CITY, BELIEVES THAT THE ENTIRE MEDICARE SHORTFALL OF $2.4 BILLION, AS REPORTED BELOW IN PART VI, LINE 6, CONSTITUTES COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY HOSPITAL FACILITIES IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITIES. THE HOSPITALS PROVIDE CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVE THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THIS SHORTFALL INCLUDES $973 THOUSAND REPORTED ON PART III, SECTION B, LINE 7, PRIMARILY FOR FEE FOR SERVICE MEDICARE PATIENTS, AS WELL AS THE UNREIMBURSED PORTION OF MEDICARE MANAGED CARE AND MEDICARE CAPITATED PROGRAMS FOR PORT CITY.
PART III, LINE 9B:	PORT CITY ENSURES THAT PATIENT ACCOUNTS ARE PROCESSED FAIRLY AND CONSISTENTLY. PORT CITY ALSO FOLLOWS DIGNITY HEALTH'S BILLING AND COLLECTION POLICY. DIGNITY HEALTH'S COLLECTION POLICY CONTAINS PROVISIONS THAT PROHIBIT THE COLLECTION OF AMOUNTS DUE FROM PATIENTS WHOM THE ORGANIZATION KNOWS QUALIFY FOR CHARITY CARE. ACCOUNTS WITH INCORRECT OR INCOMPLETE DEMOGRAPHIC INFORMATION ARE ASSIGNED TO A COLLECTION AGENCY IF THE HOSPITAL FACILITIES OR THE BILLING COMPANY RETAINED BY DIGNITY HEALTH IS UNABLE TO OBTAIN AN UPDATED ADDRESS THROUGH SKIP TRACING OR OTHER MEANS. FOR PATIENTS WHO HAVE AN APPLICATION PENDING FOR EITHER GOVERNMENT-SPONSORED FINANCIAL ASSISTANCE OR FOR ASSISTANCE UNDER DIGNITY HEALTH'S FINANCIAL ASISTANCE POLICY, OR WHERE THE PATIENT IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH THE FACILITY VIA PAYMENT PLANS, PORT CITY WILL NOT KNOWINGLY SEND THAT PATIENT'S BILL TO AN OUTSIDE COLLECTION AGENCY. LEGAL ACTION WILL NOT BE PURSUED TO COLLECT DEBTS FROM PATIENTS WHO HAVE QUALIFIED FOR CHARITY OR ARE COOPERATING IN GOOD FAITH TO RESOLVE THEIR DEBT.ON SELF-PAY ACCOUNTS THAT DO NOT MEET THE CRITERIA NOTED ABOVE, THE INITIAL DETERMINATION OF ASSIGNMENT TO A COLLECTION AGENCY WILL VARY DEPENDING ON THE NATURE OF THE ACCOUNT WITH THE FINAL DECISION BEING AT THE DISCRETION OF THE BILLING COMPANY RETAINED BY DIGNITY HEALTH. UPON ASSIGNMENT OF SUCH A PATIENT ACCOUNTS TO A COLLECTION AGENCY, PORT CITY REQUIRES THE AGENCY TO COMPLY WITH THE FAIR DEBT COLLECTION PRACTICES ACT.
PART VI, LINE 2:	IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT COMPLETED IN COLLABORATION WITH OTHER HOSPITALS, LOCAL PUBLIC HEALTH AND COMMUNITY PARTNERS IN THE HEALTHIER COMMUNITIES COALITION, ST. JOSEPH'S ASSESSES LOCAL NEEDS CONTINUOUSLY THROUGH ONGOING ENGAGEMENT IN THE HEALTHIER COMMUNITY COALITION AND A WIDE RANGE OF OTHER COMMUNITY ORGANIZATIONS, WORK GROUPS AND PROJECTS WITH PARTNERS. MANY OF THESE SPECIFIC ENGAGEMENTS ARE DESCRIBED IN SCHEDULE H, PART VI, LINE 5 BELOW. THE HOSPITALS CREATE AND MAKE WIDELY AVAILABLE TO THE PUBLIC ANNUAL COMMUNITY BENEFIT REPORTS THAT SUMMARIZE IDENTIFIED HEALTH NEEDS, UPDATE COMMUNITY DEMOGRAPHIC INFORMATION, AND REPORT ON RECENT AND PLANNED COMMUNITY HEALTH PROGRAMS, INCLUDING GOALS, OBJECTIVES AND MEASURABLE RESULTS.THE HOSPITALS UTILIZE DIGNITY HEALTH'S COMMUNITY NEED INDEX (CNI), WHICH PROVIDES AN AGGREGATE SCORE OF THE SOCIOECONOMIC BARRIERS THAT PUT RESIDENTS AT GREATER RISK OF NEEDING HEALTH SERVICES. CREATED WITH TRUVEN HEALTH ANALYTICS, THE CNI AGGREGATES NINE INDICATORS INTO FIVE SOCIOECONOMIC FACTORS KNOWN TO CONTRIBUTE TO HEALTH DISPARITY. THE FIVE INCLUDE INCOME, CULTURE/LANGUAGE, EDUCATION, HOUSING STATUS, AND INSURANCE COVERAGE. THE INDEX IS CALCULATED ANNUALLY FOR EVERY ZIP CODE IN THE UNITED STATES. RESIDENTS OF COMMUNITIES WITH THE HIGHEST CNI SCORES WERE SHOWN TO BE TWICE AS LIKELY TO EXPERIENCE PREVENTABLE HOSPITALIZATION FOR MANAGABLE CONDITIONS AS COMMUNITIES WITH THE LOWEST CNI SCORES. THE CNI PROVIDES COMPELLING EVIDENCE FOR ADDRESSING SOCIOECONOMIC BARRIERS WHEN CONSIDERING HEALTH POLICY AND LOCAL HEALTH PLANNING. THE TOOL HIGHLIGHTS HEALTH CARE DISPARITIES AND ENABLES HEALTHCARE PROVIDERS, POLICYMAKERS, AND OTHERS TO TARGET RESOURCES WHERE THEY ARE MOST NEEDED. ADDITIONAL INFORMATION ABOUT THE CNI IS ACCESSIBLE AT HTTPS://WWW.DIGNITYHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH/COMMUNITY-HEALTH-PROGRAMS-AND-REPORTS
PART VI, LINE 3:	INFORMATION ABOUT PORT CITY'S FINANCIAL ASSISTANCE PROGRAM AND A CONTACT NUMBER ARE MADE AVAILABLE TO PATIENTS AND THE PUBLIC. PATIENTS ARE INFORMED OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM VIA SIGNAGE IN ALL ADMITTING AREAS AND IN VARIOUS COMMON AREAS OF THE HOSPITAL. FINANCIAL ASSISTANCE PROGRAM INFORMATION NOTICES ARE POSTED IN THE EMERGENCY AND ADMITTING DEPARTMENTS AND AT OTHER PUBLIC PLACES AS THE PORT CITY'S FACILITY MAY ELECT. SUCH INFORMATION IS PROVIDED IN THE PRIMARY LANGUAGES SPOKEN IN THE COMMUNITIES PORT CITY'S FACILITIES SERVE. THE SIGNAGE INCLUDES NOTIFICATION THAT ALL UNINSURED PATIENTS RECEIVE AN UNINSURED DISCOUNT OF 30%, AND THAT FURTHER DISCOUNTS MAY BE PROVIDED UPON THE COMPLETION AND SUBMISSION OF A FINANCIAL ASSISTANCE APPLICATION OR WITH PROMPT PAYMENT. FINANCIAL ASSISTANCE INFORMATION, GOVERNMENT PROGRAM RESOURCE INFORMATION, TOOLS TO ASSIST PATIENTS IN FINDING HEALTH COVERAGE, ANSWERS TO FREQUENTLY ASKED BILLING QUESTIONS, AND OTHER SUCH INFORMATION CAN ALSO BE FOUND ON THE HOSPITAL'S WEBSITE AT WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/PATIENTS-AND-VISITORS/PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCE AND WWW.DIGNITYHEALTH.ORG/CENTRAL-CALIFORNIA/LOCATIONS/STJOSEPHSBEHAVIORAL/PATIENTS-AND-VISITORS/PATIENTS/BILLING-INFORMATION/FINANCIAL-ASSISTANCEAT THE POINT OF REGISTRATION, BROCHURES ARE MADE AVAILABLE TO ALL PATIENTS EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS. COPIES OF THE FINANCIAL ASSISTANCE APPLICATION ARE MADE AVAILABLE TO ALL UNINSURED PATIENTS IN ADDITION TO THE BROCHURE UPON ADMISSION TO THE FACILITY.IF FINANCIAL ASSISTANCE ELIGIBILITY IS NOT DETERMINED PRIOR TO BILLING, INITIAL BILLING STATEMENTS TO UNINSURED PATIENTS INCLUDE A REQUEST TO THE PATIENT TO PROVIDE ANY INSURANCE INFORMATION THAT WAS VALID FOR THE DATES OF SERVICE BILLED, A STATEMENT INFORMING PATIENTS WITHOUT INSURANCE COVERAGE THAT THEY MAY BE ELIGIBLE FOR A GOVERNMENT SPONSORED PROGRAM OR FACILITY FUNDED FINANCIAL ASSISTANCE, INSTRUCTIONS ON HOW TO APPLY FOR A GOVERNMENT PROGRAM OR FINANCIAL ASSISTANCE AND THE PROVISION OF SUCH APPLICATIONS. ADDITIONALLY, CONTRACT TERMS WITH COLLECTION VENDORS WORKING ON BEHALF OF PORT CITY REQUIRE ALL INITIAL STATEMENTS TO UNINSURED PATIENTS TO INCLUDE VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE FINANCIAL ASSISTANCE APPLICATION. ALSO, ANY MEMBER OF THE DIGNITY HEALTH FACILITY STAFF OR MEDICAL STAFF MAY MAKE REFERRALS OF PATIENTS FOR FINANCIAL ASSISTANCE. THE PATIENT, A FAMILY MEMBER, A CLOSE FRIEND OR AN ASSOCIATE OF THE PATIENT MAY ALSO MAKE A REQUEST FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:	THE PRIMARY SERVICE AREA OF ST. JOSEPH'S MEDICAL CENTER IS THE CITY OF STOCKTON, WITH A SECONDARY SERVICE AREA OF SAN JOAQUIN COUNTY. MANY OF THE COMMUNITIES SERVED BY THE HOSPITAL ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND THE MIGRANT FARM WORKERS SERVED BY THE HOSPITAL ARE DESIGNATED AS A MEDICALLY UNDERSERVED POPULATION.TOTAL POPULATION: 387,484WHITE - NON-HISPANIC: 22.9%BLACK/AFRICAN AMERICAN -NON-HISPANIC: 20.7%HISPANIC OR LATINO: 47.3% ASIAN/PACIFIC ISLANDER: 18.7%ALL OTHERS: 4.1%MEDIAN INCOME: $48,498BELOW POVERTY 16.1%UNEMPLOYMENT: 9.2%NO HIGH SCHOOL DIPLOMA: 24.4%MEDICAID: 11.9%UNINSURED: 6.2%OTHER AREA HOSPITALS: 7THE PRIMARY SERVICE AREA OF ST. JOSEPH'S MEDICAL BEHAVIORAL HEALTH CENTER IS THE CITY OF STOCKTON, WITH A SECONDARY SERVICE AREA OF SAN JOAQUIN COUNTY. MANY OF THE COMMUNITIES SERVED BY THE HOSPITAL ARE DESIGNATED AS MEDICALLY UNDERSERVED AREAS AND THE MIGRANT FARM WORKERS SERVED BY THE HOSPITAL ARE DESIGNATED AS A MEDICALLY UNDERSERVED POPULATION.TOTAL POPULATION: 1,281,245WHITE - NON-HISPANIC: 35.3% BLACK/AFRICAN AMERICAN -NON-HISPANIC: 5.2%; HISPANIC OR LATINO 43.6% ASIAN/PACIFIC ISLANDER 11.8%ALL OTHERS 4.0%BELOW POVERTY 11.6%UNEMPLOYMENT: 7.9%NO HIGH SCHOOL DIPLOMA: 19.7%MEDICAID: 9.7%UNINSURED: 5.5%OTHER AREA HOSPITALS: 7
PART VI, LINE 5:	PORT CITY OPERATING COMPANY LLC BOARD OF MANAGERS IS RESPONSIBLE FOR ENSURING THAT COMMUNITY HEALTH IS ONE OF THE MAJOR GOALS IN THE STRATEGIC PLANNING PROCESSS. THE BOARD OF MANAGERS IS A GROUP OF BUSINESS HEALTH EXECUTIVES WHO PROVIDE A BROAD SPECTRUM OF PERSPECTIVES ON PLANS PRESENTED FOR THEIR APPROVAL. ST. JOSEPH'S MEDICAL CENTER AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER (A DBA OF PORT CITY OPERATING COMPANY LLC) PRESIDENT IS COMMITTED TO THE COMMUNITY BENEFIT PROCESS AND ACCOUNTABLE TO DIGNITY HEALTH SYSTEM LEADERSHIP.ST. JOSEPH'S MEDICAL CENTER AND ST. JOSEPH'S BEHAVIORAL HEALTH CENTER SERVE AN IMPORTANT ROLE IN IMPROVING THE HEALTH OF THE COMMUNITY THROUGH WORKING COLLABORATIVELY WITH COMMUNITY PARTNERS, PROVIDING LEADERERSHIP AND ADVOCACY, CAREFULLY MANAGING RESOURCES, ASSISTING WITH LOCAL CAPACITY BUILDING AND PARTICIPATING IN COMMUNITY-WIDE HEALTH PLANNING. THE LEADERSHIP ROLE IS ESPECIALLY IMPORTANT IN SAN JOAQUIN COUNTY WHEREINDIVIDUAL AND COMMUNITY RESOURCES ARE VERY LIMITED.THE HEALTHIER COMMUNITY COALITION IS A CONSORTIUM OF ALL THE LOCAL HOSPITALS, THE MEDI-CAL MANAGED CARE PLANS, THE COUNTY PUBLIC HEALTH DEPARTMENT, AND NUMEROUS COMMUNITY BASED ORGANIZATIONS. THE COALITION HAS SHARED GOVERNANCE BY ALL MEMBERS, THE CHAIR POSITION ROTATES ANNUALLY, AND ST. JOSEPH'S MEDICAL CENTER SERVES AS THE FIRST FISCAL SPONSOR. THE HEALTHIER COMMUNITY COALITION PROVIDES CONTINUOUS INPUT ON THE COMMUNITY BENEFIT WORK TO THE MANAGEMENT TEAM OF ST. JOSEPH'S MEDICAL CENTER.LEADERS FROM ST. JOSEPH'S SERVE AS BOARD MEMBERS OF NUMEROUS COMMUNITY ORGANIZATIONS AND COLLABORATIVES, INCLUDING ST. MARY'S DINING ROOM, WOMEN'S CENTER YOUTH AND FAMILY SERVICES, COMMUNITY PARTNERSHIP FOR FAMILIES, SAN JOAQUIN COMPASSIONATE CARE COALLITION, O'CONNOR WOODS, ST. MARY'S HIGH SCHOOL FOUNDATION, BUSINESS COUNCIL OF SAN JOAQUIN COUNTY, THE HOSPITAL COUNCIL, AND THE COMMUNITY HEALTH LEADERSHIP COUNCIL. THE HOSPITALS HAVE DEDICATED LEADERSHIP AND A COMMUNITY HEALTH DEPARTMENT WORKING CLOSELY WITH OTHER HEALTHCARE PROVIDERS, COMMUNITY BASED ORGANIZATIONS, AND INDIVIDUALS TO DEVELOP AND SHARE RESOURCES. THE DIRECTOR OF COMMUNITY HEALTH LEADS THE DEVELOPMENT OF COMMUNITY-WIDE INITIATIVES TO ADDRESS THE PRIORITY HEALTH NEEDS FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE HOSPITALS ARE ALSO A MEMBER OF THE HOMELESS MEDICAL RECUPERATIVE CARE HEALTHCARE ADVISORY GROUP, THE CONTINUUM OF CARE, REINVENT SOUTH STOCKTON COALITION, AND THE SAN JOAQUIN HUMAN TRAFFICKING TASK FORCE. THE HOSPITALS ARE ALSO A LEAD PARTNER IN THE DEVELOPMENT OF THE SAN JOAQUIN COUNTY TRANSFORMING COMMUNITIES FOR HEALTHING, A COLLABORATIVE OF OVER 40 COMMUNITY PARTNERS FOCUSSED ON ADDRESSING TRAUMA AND ADVERSE CHILDHOOD EXPERIENCES.
PART VI, LINE 6:	PORT CITY IS 80% OWNED BY DIGNTY HEALTH AND THEREFORE AFFILIATED WITH ALL ENTITIES WITHIN DIGNITY HEALTH. AFFILIATES OF DIGNITY HEALTH ALSO PROMOTE THE HEALTH OF ADDITIONAL COMMUNITIES IN BAKERSFIELD, SAN BERNARDINO, SAN FRANCISCO, SAN ANDREAS, G RASS VALLEY/NEVADA CITY, CALIFORNIA, PHOENIX, CHANDLER AND GILBERT, ARIZONA, AND LAS VEGAS, HENDERSON, NEVADA AND IN 18 ADDITIONAL STATES THROUGH THE ALLIANCE WITHIN COMMONSPIRIT HEALTH SYSTEM. THESE AFFILIATES FOLLOW PRACTICES SIMILAR TO THOSE NOTED ABOVE IN DETERMINING THE UNMET HEALTHCARE NEEDS OF THEIR COMMUNITIES. TOTAL UNSPONSORED COMMUNITY BENEFIT EXPENSE NET OF OFFSETTING REVENUE FOR COMMONSPIRIT HEALTH AND ITS AFFILIATED CORPORATIONS, WHICH INCLUDES PORT CITY, FOR THE YEAR ENDED JUNE 30, 2020, IS $2.4 BILLION. A SUMMARY OF COMMONSPIRIT'S COMMUNITY BENEFITS CAN BE VIEWED IN THE ATTACHED COMMONSPIRIT HEALTH CONSOLIDATED FINANCIAL STATEMENTS ON PAGE 50.
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule H (Form 990) 2019

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
PORT CITY OPERATING COMPANY LLC

Employer identification number
46-5322209

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) DIGNITY HEALTH MEDICAL FOUNDATION 3400 DATA DRIVE RANCHO CORDOVA,CA95670	68-0220314	501(C)(3)	11,787,397	N/A	N/A	MEDICAL FOUNDATION SUPPORT
(2) ST JOSEPH'S FOUNDATION OF SAN JOAQUIN 1800 N CALIFORNIA STREET STOCKTON,CA95204	51-0432777	501(C)(3)	1,206,811	N/A	N/A	FOUNDATION SUPPORT
(3) CALIFORNIA HEALTH FOUNDATION AND TRUST 1215 K STREET SUITE 800 SACRAMENTO,CA95814	94-1498697	501(C)(3)	442,729	N/A	N/A	COMMUNITY HEALTH
(4) PEER RECOVERY SERVICES 1109 N CALIFORNIA ST STOCKTON,CA95202	81-2348607	501(C)(3)	85,000	N/A	N/A	COMMUNITY HEALTH
(5) UNITED WAY OF SAN JOAQUIN COUNTY 777 N PERSHING AVE STE B STOCKTON,CA95203	94-1279805	501(C)(3)	32,196	N/A	N/A	COMMUNITY HEALTH
(6) WOMENS CENTER YOUTH & FAMILY SERVICES 620 N SAN JOAQUIN ST STOCKTON,CA95202	94-2341360	501(C)(3)	26,180	N/A	N/A	COMMUNITY HEALTH
(7) HELPING OTHERS PROVIDE ENCOURAGEMENT MINISTRIES PO BOX 841 MANTECA,CA95336	68-0235846	501(C)(3)	20,000	N/A	N/A	COMMUNITY HEALTH
(8) GRAND CANYON UNIVERSITY 3300 W CAMELBACK RD PHOENIX,AZ85017	47-2507725	501(C)(3)	5,500	N/A	N/A	EDUCATION SUPPORT
(9) ROMAN CATHOLIC BISHOP OF STOCKTON 212 N SAN JOAQUIN ST STOCKTON,CA95202	94-1532129	501(C)(3)	5,100	N/A	N/A	COMMUNITY HEALTH

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) PROVISION OF FOOD/MEALS	14	0	30,547	BOOK	FOOD/CLOTHING
(2) MEDICAL SUPPLIES/EQUIPMENT TO PATIENTS/INDIGENTS	858	0	8,295	BOOK	WHEEL CHAIRS, WALKERS, COMMODES
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	DONATIONS ARE PROVIDED TO THE COMMUNITY TO FURTHER THE MISSION OF THE MEDICAL CENTER AND SUPPORT VARIOUS COMMUNITY PROGRAMS. ST. JOSEPH'S MEDICAL CENTER PROVIDES DONATIONS TO SUPPORT COMMUNITY PROGRAMS THAT MEET SPECIFIC CRITERIA THROUGH ITS COMMUNITY HEALTH DEPARTMENT AND ALSO DONATES DIRECTLY TO VARIOUS COMMUNITY EVENTS AND PROGRAMS THROUGH THE MARKETING AND BUSINESS DEVELOPMENT DEPARTMENTS.

Schedule I (Form 990) 2019

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JON VANBOENING BOARD MEMBER	(i) (ii)	0 ------------- 656,567	0 ------------- 699,420	0 ------------- 189,373	0 ------------- 127,931	0 ------------- 92,632	0 ------------- 1,765,923	0 ------------- 121,270
2DONALD WILEY PRESIDENT AND CEO	(i) (ii)	0 ------------- 459,708	0 ------------- 419,975	0 ------------- 333,089	0 ------------- 86,587	0 ------------- 52,560	0 ------------- 1,351,919	0 ------------- 284,544
3JOHN PETERSDORF VICE CHAIR	(i) (ii)	0 ------------- 509,140	0 ------------- 600,301	0 ------------- 7,718	0 ------------- 106,423	0 ------------- 61,897	0 ------------- 1,285,479	0 ------------- 0
4RICHARD CARVOLTH MD BOARD MEMBER	(i) (ii)	0 ------------- 479,809	0 ------------- 208,256	0 ------------- 6,599	0 ------------- 69,154	0 ------------- 24,535	0 ------------- 788,353	0 ------------- 0
5KEVIN WALTERS BOARD MEMBER	(i) (ii)	0 ------------- 401,065	0 ------------- 192,009	0 ------------- 4,902	0 ------------- 61,242	0 ------------- 40,115	0 ------------- 699,333	0 ------------- 0
6KARL SILBERSTEIN FORMER OFFICER	(i) (ii)	0 ------------- 47,538	0 ------------- 385,556	0 ------------- 19,013	0 ------------- 46,552	0 ------------- 4,722	0 ------------- 503,381	0 ------------- 0
7ANDREA NIKKI OCHOA CHIEF FINANCIAL OFFICER	(i) (ii)	0 ------------- 214,097	0 ------------- 53,964	0 ------------- 1,562	0 ------------- 31,741	0 ------------- 14,761	0 ------------- 316,125	0 ------------- 0

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 4B	SCHEDULE J, PART I, LINE 4A CERTAIN OFFICERS PARTICIPATE IN A SEVERANCE PLAN THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 1 TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2019. SCHEDULE J, PART I, LINE 4B CERTAIN OFFICERS ARE ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS PURSUANT TO THE PLAN OCCURRED DURING 2019. DIGNITY HEALTH'S KEY EMPLOYEES AND CERTAIN OFFICERS AND HIGHLY COMPENSATED EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN NON-QUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NON-QUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. PAYMENTS PURSUANT TO THE PLAN ARRANGEMENTS FOR TWO LISTED PERSONS DURING 2019 INCLUDE J. VANBOENING; $121,270 AND K. SILBERSTEIN; $284,544. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
SCHEDULE J, PART I, LINE 3	ALTHOUGH THE ORGANIZATION DOES NOT EMPLOY PERSONNEL, THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15A FOR ADDITIONAL INFORMATION.
SCHEDULE J, PART III SUPPLEMENTAL DISCLOSURES	THE ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES DIGNITY HEALTH SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND DIGNITY HEALTH'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2019.

Schedule J (Form 990) 2019

Additional Data

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SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..	X		600	RESALE VALUE
5 Clothing and household goods .......	X		600	RESALE VALUE
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( COVID - FOOD/MEDICAL SUPPLIES )	X	165	88,671	COMPARABLE SALE
26 Other ( FLOWERS )	X	4	11,600	COMPARABLE SALE
27 Other ( TOYS )	X	10	9,300	COMPARABLE SALE
28 Other ( PRAYER POCKETS )	X	4	216	COMPARABLE SALE
Other ( GOODIE BAGS )	X	1	30	COMPARABLE SALE

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference

Explanation

PART I, COLUMN (B):

TOYS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. COVID FOOD AND MEDICAL SUPPLIES: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED. FLOWERS/GOODIE BAGS/PRAYER POCKETS: THE ORGANIZATION IS REPORTING A COMBINATION OF BOTH THE NUMBER OF CONTRIBUTIONS AND THE NUMBER OF ITEMS RECEIVED.

Schedule M (Form 990) (2019)

Additional Data

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SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Return Reference	Explanation
FORM 990, PART V, LINE 2A	THE ORGANIZATION DOES NOT HAVE EMPLOYEES. THE ORGANIZATION UTILIZES THE EMPLOYEES OF DIGNITY HEALTH PER THE EMPLOYEE LEASE AGREEMENT. THE SALARIES OF THESE EMPLOYEES ARE INCLUDED ON DIGNITY HEALTH'S FORM W-3 AND FEDERAL EMPLOYMENT TAX RETURNS.
FORM 990, PART VI, SECTION A, LINE 2	CERTAIN REPORTABLE INDIVIDUALS HAVE A BUSINESS RELATIONSHIPS WITH THE RELATED ENTITIES OF PORT CITY OPERATING COMPANY LLC (INCLUDING FOR-PROFIT SUBSIDIARIES OR JOINT VENTURES) AS A RESULT OF SERVING AS OFFICERS OR BOARD MEMBERS OF THOSE ENTITIES. BOARD OFFICER MEMBERSHIP ON THE GOVERNING BODIES OF THOSE RELATED ENTITIES ARE AS FOLLOWS. DONALD WILEY, ANDREA NIKKI OCHOA - BUSINESS RELATIONSHIP
FORM 990, PART VI, SECTION A, LINE 6	PORT CITY IS 80% OWNED BY DIGNITY HEALTH AND 20% BY KFH, BOTH 501(C)(3) EXEMPT ORGANIZATIONS. DIGNITY HEALTH IS THE MANAGING MEMBER OF PORT CITY, LLC. ON FEBRUARY 1, 2019, DIGNITY HEALTH AND CATHOLIC HEALTH INITIATIVES ("CHI"), A COLORADO NONPROFIT CORPORATION, EFFECTED A BUSINESS COMBINATION. ON THAT DATE, CHI CHANGED ITS NAME TO COMMONSPIRIT HEALTH AND BECAME THE SOLE CORPORATE MEMBER OF DIGNITY HEALTH. COMMONSPIRIT HEALTH IS A CATHOLIC HEALTHCARE SYSTEM SPONSORED BY THE PUBLIC JURIDIC PERSON, CATHOLIC HEALTH CARE FEDERATION (CHCF").
FORM 990, PART VI, SECTION A, LINE 7A	DIGNITY HEALTH AND KFH, KNOWN AS THE COMPANY MEMBERS, APPOINT A BOARD OF MANAGERS.
FORM 990, PART VI, SECTION A, LINE 7B	RESERVED RIGHTS OF THE COMPANY MEMBERS INCLUDE: SELL, LEASE, EXCHANGE OR OTHERWISE DISPOSE OF ALL, OR SUBSTANTIALLY ALL, OF THE ORGANIZATION'S PROPERTY, WITH OR WITHOUT THE GOODWILL, OUTSIDE OF THE ORDINARY COURSE OF THE ORGANIZATION'S ACTIVITIES, APPROVE A MERGER OR CONVERSION, UNDERTAKE ANY OTHER ACT OUTSIDE OF THE ORDINARY COURSE OF THE ORGANIZATION'S ACTIVITIES, AND AMEND THE ORGANIZATION'S AGREEMENT.
FORM 990, PART VI, SECTION B, LINE 11B	THE PORT CITY OPERATING COMPANY LLC CFO REVIEWED THE FORM 990. IN ADDITION, COMMONSPIRIT HEALTH'S TAX DEPARTMENT WORKED CLOSELY WITH AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. DUE TO TIMING, THE FORM 990 WILL BE REVIEWED BY THE BOARD OF MANAGERS AND/OR SUBCOMMITTEE OF THE BOARD OF MANAGERS SUBSEQUENT TO FILING WITH THE INTERNAL REVENUE SERVICE. COPIES OF FORM 990, EXCLUDING COMPENSATION INFORMATION WERE PROVIDED VIA EMAIL TO EACH BOARD MEMBER PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	DIGNITY HEALTH EMPLOYEES HAVE ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. DURING THE PERIOD JULY 1, 2019 THROUGH JUNE 30, 2020, DIGNITY HEALTH WAS SUBJECT TO WRITTEN CONFLICT OF INTEREST POLICIES (THE "COI POLICIES."). THESE POLICIES, PROVIDE FOR THE DISCLOSURE AND SUBSEQUENT REVIEW AND MANAGEMENT OF CONFLICTS OF INTEREST THAT MAY EXIST FOR MEMBERS OF DIGNITY HEALTH'S GOVERNING BODIES, INCLUDING ITS BOARD OF DIRECTORS AND BOARD COMMITTEES, AS WELL AS DIGNITY HEALTH'S OFFICERS AND EXECUTIVE LEADERS, KEY EMPLOYEES, MANAGEMENT PERSONNEL AT THE VICE PRESIDENT LEVEL AND ABOVE, AND ANY OTHER DESIGNATED PERSONNEL ("COVERED PERSONS"). ALL COVERED PERSONS ARE REQUIRED TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS ARISING FROM THE BUSINESS, OWNERSHIP, FINANCIAL AND PERSONAL INTERESTS HELD BY SUCH COVERED PERSONS OR THEIR FAMILY MEMBERS. COVERED PERSONS ARE REQUIRED TO DISCLOSE TO THEIR SUPERVISORS OR RELEVANT DECISION MAKERS ANY INTEREST THAT MAY PRESENT A CONFLICT OF INTEREST, OR THE APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE IS REQUIRED ON A TRANSACTIONAL BASIS AT THE TIME SUCH CONFLICTS ARISE, WHEN AN INDIVIDUAL BECOMES A COVERED PERSON (E.G. UPON HIRING OR UPON PROMOTION), AND ANNUALLY THEREAFTER. AS PART OF THE ANNUAL DISCLOSURE SURVEY CONDUCTED PURSUANT TO THE COI POLICIES, EACH COVERED PERSON IS REQUIRED TO CERTIFY THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE COI POLICY OR COI POLICIES APPLICABLE TO HIS/HER POSITION; (2) HAS READ THE COI POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE COI POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST DISCLOSURE SURVEY AS REQUIRED BY THE COI POLICIES. THE INFORMATION FROM THE ANNUAL DISCLOSURE SURVEY IS USED TO MONITOR AND MANAGE DISCLOSED CONFLICTS OF INTEREST AND ASSURE DECISIONS ARE MADE IN THE ORGANIZATION'S BEST INTERESTS. THE PROCEDURES FOR ADDRESSING A CONFLICT OF INTEREST RELATED TO A PROPOSED TRANSACTION IN THE CASE OF GOVERNING BODIES REQUIRE THAT THE BOARD SHALL CAREFULLY SCRUTINIZE AND MUST IN GOOD FAITH EITHER APPROVE OR DISAPPROVE ANY TRANSACTION IN WHICH DIGNITY HEALTH OR A DIGNITY HEALTH ENTITY IS A PARTY AND IN WHICH THE DIRECTOR EITHER: HAS A MATERIAL FINANCIAL INTEREST OR IS A DIRECTOR OR CORPORATE OFFICER OF THE OTHER PARTY (OTHER THAN A DIGNITY HEALTH-AFFILIATED ORGANIZATION). THE BOARD MUST APPROVE THE TRANSACTION BY MAJORITY OF THE DIRECTORS ON THE BOARD, WITHOUT COUNTING THE VOTE OF ANY INDIVIDUAL WHO HAS AN INTEREST IN THE TRANSACTION. IN REVIEWING SUCH TRANSACTIONS BETWEEN DIGNITY HEALTH OR DIGNITY HEALTH ENTITIES AND VENDORS OR OTHER CONTRACTORS WHO ARE, OR ARE AFFILIATED WITH, DIRECTORS, THE BOARD SHALL ACT NO MORE OR LESS FAVORABLY THAN IT WOULD IN REVIEWING TRANSACTIONS WITH UNRELATED THIRD PARTIES. THE TRANSACTION WILL NOT BE APPROVED UNLESS THE BOARD DETERMINES THAT THE TRANSACTION IS FAIR TO DIGNITY HEALTH OR THE DIGNITY HEALTH ENTITY.
FORM 990, PART VI, SECTION C, LINE 19	FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION IS INCLUDED IN COMMONSPIRIT HEALTHS' CONSOLIDATED FINANCIAL STATEMENTS WHICH ARE AVAILABLE ON BOTH COMMONSPIRIT HEALTH'S AND DIGNITY HEALTH'S WEBSITES AND UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15	THE ORGANIZATION'S PERSONNEL IS COMPENSATED BY DIGNITY HEALTH. FOR 2019 COMPENSATION, THE RELATED ORGANIZATION, COMMONSPIRIT HEALTH'S BOARD OF STEWARDSHIP TRUSTEES, APPOINTS A HUMAN RESOURCES AND COMPENSATION COMMITTEE, COMPRISED OF INDEPENDENT DIRECTORS, WHO ARE ACCOUNTABLE FOR SETTING REASONABLE COMPENSATION PACKAGES FOR THE TOP MANAGEMENT OFFICIALS. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE APPROVES, CONSISTENT WITH THE ORGANIZATION'S PHILOSOPHY AND PRINCIPLES, THE ANNUAL PERFORMANCE GOALS AND CRITERIA TO BE USED IN DETERMINING MERIT INCREASES AND VARIABLE COMPENSATION CRITERIA FOR OFFICERS AND KEY EMPLOYEES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE ALSO ENGAGES OUTSIDE LEGAL COUNSEL AS NECESSARY AND QUALIFIED INDEPENDENT COMPENSATION AND BENEFITS SPECIALISTS (INDEPENDENT EXPERTS) TO REVIEW, ANALYZE AND PROVIDE BENCHMARKING DATA FOR THE TOTAL COMPENSATION AND BENEFITS PACKAGES OF OFFICERS AND KEY EXECUTIVES. APPROPRIATE COMPARABLE DATA IS OBTAINED FROM THE INDEPENDENT EXPERTS, (E.G., TOTAL ECONOMIC BENEFITS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR SIMILAR JOB RESPONSIBILITIES). KEY DELIBERATIONS OF THE COMMITTEE ARE DOCUMENTED IN MEETING MINUTES WHICH ARE APPROVED AT THE NEXT COMMITTEE MEETING AND PROVIDED TO THE BOARD OF DIRECTORS. THE DOCUMENTATION OF THE DELIBERATIONS INCLUDES (A) THE TERMS OF THE AGREEMENT APPROVED AND THE DATE APPROVED; (B) THE MEMBERS OF THE COMMITTEE WHO WERE PRESENT DURING DISCUSSION OF THE APPROVED AGREEMENT AND THOSE WHO VOTED ON IT; AND (C) THE COMPARABILITY DATA OBTAINED AND RELIED UPON BY THE COMMITTEE AND HOW THE DATA WAS OBTAINED.
FORM 990, PART VII, SECTION A	R CARVOLTH, MD, J PETERSDORF, J VANBOENING, K SILBERSTEIN AND KEVIN WALTERS RECEIVED COMPENSATION FOR SERVICES PROVIDED TO A RELATED ORGANIZATION, DIGNITY HEALTH. ANDREA N OCHOA AND D WILEY ARE EMPLOYEES OF DIGNITY HEALTH BUT PROVIDE SERVICES AS OFFICERS TO PORT CITY.
FORM 990, PART IX, LINE 11G	REVENUE CYCLE SERVICES: PROGRAM SERVICE EXPENSES 16,210,005. MANAGEMENT AND GENERAL EXPENSES 281,489. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 16,491,494. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 324,781,942. MANAGEMENT AND GENERAL EXPENSES 50,691,841. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 375,473,783. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 29,684,196. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,684,196. MAINTENANCE/REPAIRS: PROGRAM SERVICE EXPENSES 8,134,932. MANAGEMENT AND GENERAL EXPENSES 1,269,697. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,404,629. PROFESSIONAL FEES/CONSULTING: PROGRAM SERVICE EXPENSES 2,368,363. MANAGEMENT AND GENERAL EXPENSES 369,653. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,738,016. LAUNDRY /LINEN: PROGRAM SERVICE EXPENSES 1,070,200. MANAGEMENT AND GENERAL EXPENSES 167,036. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,237,236. JANITORIAL/LANDSCAPE/STORAGE: PROGRAM SERVICE EXPENSES 574,106. MANAGEMENT AND GENERAL EXPENSES 89,606. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 663,712. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,546,848. MANAGEMENT AND GENERAL EXPENSES 397,511. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,944,359.
FORM 990, PART XI, LINE 9:	CAPITAL FUNDING - SAN JOAQUIN QUALITY CARE NETWORK -510,000. PRIOR YEAR DONATION REFUND 10,000. CURRENT YEAR CHANGE IN ACCOUNTING - ASC 842 ADJUSTMENT -163,911. GAIN ON ADOPTION OF ASU 2017-17 6,925,778. TRUE UP OF FY19 PENSION ENTRIES 1,275,268. CHANGE OF OWNERSHIP INTEREST-JV -203,741. TRUE UP OF FY19 ADJUSTMENT DUE TO ACQUISITION ACCOUNTING -46,137.
FORM 990, PART XII, LINE 2C	THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR.
FORM 990, PART XII, LINE 3B	THE ORGANIZATION'S FEDERAL AWARDS WERE INCLUDED IN COMMONSPIRIT'S CONSOLIDATED UNIFORM GUIDANCE AUDITED SCHEDULE OF FEDERAL EXPENDITURES FOR THE PERIOD OF JULY 1, 2019, TO JUNE 30, 2020.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

PORT CITY OPERATING COMPANY LLC

Employer identification number

46-5322209

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ALEGENT CREIGHTON CLINIC 12809 W DODGE RD OMAHA,NE68154 47-0765154	HOSPITAL	NE	501(C)(3)	LINE 3	ACH		No
(2)ALEGENT CREIGHTON HEALTH 12809 W DODGE RD OMAHA,NE68154 47-0757164	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(3)ALEGENT HEALTH - BERGAN MERCY HEALTH SYSTEM 7500 MERCY RD OMAHA,NE68124 47-0484764	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(4)ALEGENT HEALTH - IMMANUEL MEDICAL CENTER 6901 N 72ND ST OMAHA,NE68122 47-0376615	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(5)ALEGENT HEALTH - MEMORIAL HOSPITAL SCHUYLER 104 W 17TH ST SCHUYLER,NE68661 47-0399853	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(6)ALEGENT HEALTH - MERCY HOSPITAL CORNING IOWA PO BOX 368 CORNING,IA50841 42-0782518	HOSPITAL	IA	501(C)(3)	LINE 3	CHI NEBRASKA		No
(7)ALEGENT HEALTH-COMMUNITY MEMORIAL HOSP OF MISSOURI VALLEY IA 631 N 8TH ST MISSOURI VALLEY,IA51555 42-0776568	HOSPITAL	IA	501(C)(3)	LINE 3	CHI NEBRASKA		No
(8)ALVERNA APARTMENTS 300 SE 8TH AVE LITTLE FALLS,MN56345 41-1351177	LONG-TERM CARE	MN	501(C)(3)	LINE 10	CSH		No
(9)APPLETREE COURT 601 OAK ST BRECKENRIDGE,MN56520 41-1850500	SENIOR LIVING	MN	501(C)(3)	LINE 10	SFH		No
(10)ARROYO GRANDE COMMUNITY HOSPITAL FOUNDATION 345 S HALCYON RD ARROYO GRANDE,CA93420 20-3256066	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(11)BAKERSFIELD MEMORIAL HOSPITAL 420 34TH STREET BAKERSFIELD,CA93301 95-1802779	HOSPITAL	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(12)BARROW FOUNDATION UK 13 CHURCH STREET NUNNEY,ENGLANDBA11 4LW UK 31-1724184	FUNDRAISING FOUNDATION	UK	501(C)(3)	LINE 12D, III-O	N/A		No
(13)BARROW NEUROLOGICAL FOUNDATION 350 WEST THOMAS ROAD PHOENIX,AZ85013 86-0174371	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 7	DIGNITY HEALTH		No
(14)BAYLOR ST LUKE'S HEALTH VENTURES 17200 ST LUKES WAY STE 170 THE WOODLANDS,TX77384 27-4499340	PHYSICIANS	TX	501(C)(3)	LINE 12A, I	SLCHS		No
(15)BAYLOR ST LUKE'S MEDICAL GROUP 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0458535	PHYSICIANS	TX	501(C)(3)	LINE 3	SLHS		No
(16)BORNEMANN HEALTHCARE CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2187242	HEALTHCARE	PA	501(C)(3)	LINE 12A, I	CSH		No
(17)BRAZOSPORT HEALTH FOUNDATION INC 1 WEST WAY CT LAKE JACKSON,TX77566 76-0080110	FUNDRAISING FOUNDATION	TX	501(C)(3)	LINE 12A, I	BRHS		No
(18)BRAZOSPORT REGIONAL PHYSICIAN SERVICES 100 MEDICAL DRIVE LAKE JACKSON,TX77566 80-0240261	PHYSICIANS	TX	501(C)(3)	LINE 3	BRHS		No
(19)BURLESON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2759890	HOSPITAL	TX	501(C)(3)	LINE 3	SJSC		No
(20)BURLESON ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2913931	HEALTHCARE	TX	501(C)(3)	LINE 10	SJSC		No
(21)CALIFORNIA HOSPITAL MEDICAL CENTER FOUNDATION 1401 SOUTH GRAND AVENUE LOS ANGELES,CA90015 95-4000909	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY COMMUNITY CARE		No
(22)CARRINGTON HEALTH CENTER 800 N 4TH ST CARRINGTON,ND58421 45-0227311	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(23)CATHOLIC HEALTH INITIATIVES - COLORADO 9100 EAST MINERAL CIRCLE CENTENNIAL,CO80112 84-0405257	HOSPITAL	CO	501(C)(3)	LINE 3	CSH		No
(24)CATHOLIC HEALTH INITIATIVES - IOWA CORP 1111 6TH AVE DES MOINES,IA50314 42-0680448	HOSPITAL	IA	501(C)(3)	LINE 3	CSH		No
(25)CATHOLIC HEALTH INITIATIVES COLORADO FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS,CO80920 84-0902211	FUNDRAISING FOUNDATION	CO	501(C)(3)	LINE 7	CHIC		No
(26)CATHOLIC HEALTH INITIATIVES NATIONAL FOUNDATION 1150 KELLY JOHNSON BLVD 204 COLORADO SPRINGS,CO80920 27-0930004	HEALTHCARE	CO	501(C)(3)	LINE 12A, I	CSH		No
(27)CATHOLIC HEALTH INITIATIVES VIRTUAL HEALTH SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-0992796	PHYSICIANS	CO	501(C)(3)	LINE 12A, I	CHINS		No
(28)CENTENNIAL MEDICAL GROUP INC 2700 STEWART PKWY ROSEBURG,OR97471 26-3946191	SURGERY CENTER	OR	501(C)(3)	LINE 10	MMC		No
(29)CENTRAL CALIFORNIA HEALTH CENTERS 300 OLD RIVER ROAD STE 200 BAKERSFIELD,CA93311 84-4171789	CLINIC	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(30)CENTRAL KANSAS MEDICAL CENTER 3515 BROADWAY GREAT BEND,KS67530 48-0543724	HOSPITAL	KS	501(C)(3)	LINE 3	CSH		No
(31)CHI HEALTH CONNECT AT HOME - FARGO 4816 AMBER VALLEY PKWY S FARGO,ND58104 27-1966847	HOME HEALTH	MN	501(C)(3)	LINE 10	CSH		No
(32)CHI HEALTH FOUNDATION 12809 W DODGE RD OMAHA,NE68154 47-0648586	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	ACH		No
(33)CHI KENTUCKY INC 3900 OLYMPIC BLVD STE 400 ERLANGER,KY41018 20-2741651	INVESTMENTS	KY	501(C)(3)	LINE 12A, I	CSH		No
(34)CHI LIVING COMMUNITIES 5942 RENAISSANCE PLACE STE A TOLEDO,OH43623 34-1892096	SENIOR LIVING	OH	501(C)(3)	LINE 12A, I	SFH		No
(35)CHI MEMORIAL HOSPITAL - GEORGIA 100 GROSS CRESCENT CIRCLE FORT OGLETHORPE,GA30742 82-2748395	HOSPITAL	GA	501(C)(3)	LINE 3	MHCS		No
(36)CHI NATIONAL HOME CARE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-1261716	HEALTHCARE	CO	501(C)(3)	LINE 10	CHI NS		No
(37)CHI NATIONAL SERVICES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 45-2532084	HEALTHCARE	CO	501(C)(3)	LINE 12A, I	CSH		No
(38)CHI NEBRASKA 12809 WEST DODGE ROAD OMAHA,NE68510 36-3233121	HEALTHCARE	NE	501(C)(3)	LINE 12A, I	CSH		No
(39)CHI ST JOSEPH CHILDREN'S HEALTH 1929 LINCOLN HWY E STE 150 LANCASTER,PA17602 23-2342997	HEALTHCARE	PA	501(C)(3)	LINE 12A, I	CSH		No
(40)CHI ST JOSEPH'S CHILDREN 1516 5TH ST NW ALBUQUERQUE,NM87102 71-0897107	COMMUNITY	NM	501(C)(3)	LINE 12A, I	CSH		No
(41)CHI ST VINCENT HOSPITAL HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 71-0236913	HOSPITAL	AR	501(C)(3)	LINE 3	CHISVHS		No
(42)CHI ST VINCENT HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 26-1125064	HOLDING CO	AR	501(C)(3)	LINE 12B, II	SVIMC		No
(43)CHI ST VINCENT MEDICAL GROUP HOT SPRINGS 300 WERNER ST HOT SPRINGS,AR71913 26-1125131	PHYSICIANS	AR	501(C)(3)	LINE 3	CHISVHS		No
(44)COMMONSPIRIT HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0617373	HEALTHCARE	CO	501(C)(3)	LINE 12A, I	N/A		No
(45)COMMONSPIRIT HEALTH OPERATING INVESTMENT POOL LLC 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 85-0919176	INVESTMENTS	CA	501(C)(3)	LINE 12A, I	CSH		No
(46)COMMONSPIRIT HEALTH RESEARCH INSTITUTE 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-1050565	HEALTHCARE	CO	501(C)(3)	LINE 12A, I	CSH		No
(47)COMMUNITY HOSPITAL OF SAN BERNARDINO 1805 MEDICAL CENTER DRIVE SAN BERNARDINO,CA92411 95-1643373	HOSPITAL	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(48)COMMUNITY LIMITED CARE DIALYSIS CENTER 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 23-7419853	HOLDING CO	OH	501(C)(4)	N/A	GSH		No
(49)COMMUNITY MEMORIAL HOSPITAL MEDICAL SERVICE FOUNDATION 631 N 8TH ST MISSOURI VALLEY,IA51555 42-1294399	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 12A, I	AH-CMHMV		No
(50)CONTINUING CARE HOSPITAL ONE SAINT JOSEPH DRIVE LEXINGTON,KY40504 61-1400619	HOSPITAL	KY	501(C)(3)	LINE 3	SJHS		No
(51)DIGNITY COMMUNITY CARE 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 81-5009488	HOSPITAL	CO	501(C)(3)	LINE 3	CSH		No
(52)DIGNITY HEALTH 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 94-1196203	HOSPITAL	CA	501(C)(3)	LINE 3	CSH		No
(53)DIGNITY HEALTH CONNECTED LIVING 200 MERCY OAKS DRIVE REDDING,CA96003 23-7115371	SENIOR CENTER SERVICES	CA	501(C)(3)	LINE 7	DIGNITY HEALTH		No
(54)DIGNITY HEALTH FOUNDATION 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 46-2037641	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(55)DIGNITY HEALTH FOUNDATION - INLAND EMPIRE 2101 N WATERMAN AVENUE SAN BERNARDINO,CA92404 23-7440086	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(56)DIGNITY HEALTH FOUNDATION EAST VALLEY 475 SOUTH DOBSON ROAD CHANDLER,AZ85224 74-2418514	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(57)DIGNITY HEALTH HPL SELF-INSURANCE TRUST 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 94-3006034	SELF INSURANCE	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(58)DIGNITY HEALTH INSURANCE NEVADA LTD 185 BERRY STREET STE 200 SAN FRANCISCO,NV94107 81-3800752	SELF INSURANCE	NV	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(59)DIGNITY HEALTH MEDICAL FOUNDATION 3400 DATA DRIVE RANCHO CORDOVA,CA95670 68-0220314	MULTI-SPECIALTY OUTPATIENT MEDICAL CLINIC	CA	501(C)(3)	LINE 12A, I	DIGNITY COMMUNITY CARE		No
(60)DIGNITY HEALTH WORKERS COMP SELF-INSURANCE TRUST 185 BERRY STREET STE 200 SAN FRANCISCO,CA94107 94-6612446	SELF INSURANCE	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(61)DOMINICAN HEALTH SERVICES 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 77-0056778	COMMUNITY HEALTH SYSTEM	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(62)DOMINICAN HOSPITAL FOUNDATION 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 94-2450442	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(63)DOMINICAN OAKS CORPORATION 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 77-0127719	OPERATION AND MANAGEMENT OF HOUSING COMPLEX TO ELDERLY PERSONS	CA	501(C)(3)	LINE 10	DHS		No
(64)EAST TEXAS CLINICAL SERVICES 2801 VIA FORTUNA SUITE 500 AUSTIN,TX78746 45-4736213	HEALTHCARE	TX	501(C)(3)	LINE 12A, I	SLHS		No
(65)ENUMCLAW REGIONAL HOSPITAL ASSOCIATION 1455 BATTERSBY AVE ENUMCLAW,WA98022 91-0715805	HOSPITAL	WA	501(C)(3)	LINE 3	FHS		No
(66)FLAGET HEALTHCARE INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 61-1345363	HOSPITAL	KY	501(C)(3)	LINE 3	KOH		No
(67)FLAGET MEMORIAL HOSPITAL FOUNDATION INC 4305 NEW SHEPHERDSVILLE RD BARDSTOWN,KY40004 56-2351341	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 12A, I	FH		No
(68)FRANCISCAN CARE CENTER 4111 N HOLLAND-SYLVANIA RD TOLEDO,OH43623 34-1931806	HEALTHCARE	OH	501(C)(3)	LINE 10	CHILC		No
(69)FRANCISCAN FOUNDATION 1717 SOUTH J ST TACOMA,WA98405 91-1145592	FUNDRAISING FOUNDATION	WA	501(C)(3)	LINE 10	FHS		No
(70)FRANCISCAN HEALTH SYSTEM 1717 SOUTH J ST TACOMA,WA98405 91-0564491	HOSPITAL	WA	501(C)(3)	LINE 3	CSH		No
(71)FRANCISCAN HEALTH VENTURES FKA SJMGROUP TACOMA FNC CTR BLDG 1145 BROADWAY TACOMA,WA98402 43-1882377	PHYSICIANS	MO	501(C)(3)	LINE 10	CSH		No
(72)FRANCISCAN MEDICAL GROUP 1313 BROADWAY STE 200 TACOMA,WA98402 91-1939739	HEALTHCARE	WA	501(C)(3)	LINE 10	FHS		No
(73)FRANCISCAN VILLA OF SOUTH MILWAUKEE INC 3601 S CHICAGO AVE SOUTH MILWAUKEE,WI53172 39-1093829	HEALTHCARE	WI	501(C)(3)	LINE 10	CSH		No
(74)FRENCH HOSPITAL MEDICAL CENTER FOUNDATION 1911 JOHNSON AVENUE SAN LUIS OBISPO,CA93401 20-3256125	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY COMMUNITY CARE		No
(75)GARRISON MEMORIAL HOSPITAL 407 THIRD AVENUE SOUTHEAST GARRISON,ND58540 45-0227752	HOSPITAL	ND	501(C)(3)	LINE 3	SAMC		No
(76)GLENDALE MEMORIAL HEALTH FOUNDATION 1420 SOUTH CENTRAL AVENUE GLENDALE,CA91204 95-3625651	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY COMMUNITY CARE		No
(77)GLOBAL HEALTH INITIATIVES 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 20-1536108	MINISTRIES	CO	501(C)(3)	LINE 12A, I	CSH		No
(78)GOOD SAMARITAN COLLEGE OF NURSING & HEALTH SCIENCE 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 31-1778403	EDUCATION	OH	501(C)(3)	LINE 2	GSH		No
(79)GOOD SAMARITAN FOUNDATION OF CINCINNATI INC 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 31-1206047	FUNDRAISING FOUNDATION	OH	501(C)(3)	LINE 12A, I	GSH		No
(80)GOOD SAMARITAN HOSPITAL PO BOX 1990 KEARNEY,NE68848 47-0379755	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(81)GOOD SAMARITAN HOSPITAL FOUNDATION 111 W 31ST ST KEARNEY,NE68847 47-0659443	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	GSH		No
(82)HARRISON MEDICAL CENTER 2520 CHERRY AVE BREMERTON,WA98310 91-0565546	HOSPITAL	WA	501(C)(3)	LINE 3	FHS		No
(83)HARRISON MEDICAL CENTER FOUNDATION 2520 CHERRY AVE BREMERTON,WA98310 91-1197626	FUNDRAISING FOUNDATION	WA	501(C)(3)	LINE 7	HMC		No
(84)HEALTH FOUNDATION OF KENTUCKYONE INC 1451 HARRODSBURG RD STE D-308 LEXINGTON,KY40504 83-2170324	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 12B, II	KOH		No
(85)HEALTHCARE AND WELLNESS FOUNDATION 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 76-0761782	FUNDRAISING FOUNDATION	MN	501(C)(3)	LINE 12A, I	SFMC		No
(86)HIGHLINE MEDICAL CENTER 16251 SYLVESTER RD SW BURIEN,WA98166 91-0712166	HOSPITAL	WA	501(C)(3)	LINE 3	FHS		No
(87)HOUSE OF MERCY 1111 6TH AVE DES MOINES,IA50314 42-1323808	SHELTER	IA	501(C)(3)	LINE 7	CHI-IA CORP		No
(88)JEWISH HOSPITAL AND ST MARY'S HEALTHCARE INC 250 E LIBERTY ST STE 500 LOUISVILLE,KY40202 61-1029768	HOSPITAL	KY	501(C)(3)	LINE 3	KOH		No
(89)KENTUCKYONE HEALTH INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1029769	HEALTHCARE	KY	501(C)(3)	LINE 12B, II	CSH		No
(90)KENTUCKYONE HEALTH MEDICAL GROUP INC 100 E LIBERTY ST STE 800 LOUISVILLE,KY40202 61-1352729	HEALTHCARE	KY	501(C)(3)	LINE 10	JHSMH		No
(91)LAKEWOOD HEALTH CENTER 600 MAIN AVE S BAUDETTE,MN56623 41-0758434	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(92)LAKEWOOD REGIONAL HEALTHCARE FOUNDATION 600 MAIN AVE S BAUDETTE,MN56623 41-1893795	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 7	LHC		No
(93)LISBON AREA HEALTH SERVICES 905 MAIN ST LISBON,ND58054 82-0558836	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(94)LUFKIN VISION ACQUISITIONS PO BOX 1447 LUFKIN,TX75901 82-0563768	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	MHSET		No
(95)MADISON ST JOSEPH HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2761145	HOSPITAL	TX	501(C)(3)	LINE 3	SJSC		No
(96)MADONNA MANOR INC 2344 AMSTERDAM ROAD VILLA HILLS,KY51017 61-0654635	LIVING ASSIST	KY	501(C)(3)	LINE 10	CHILC		No
(97)MARIAN REGIONAL MEDICAL CENTER FOUNDATION 1400 E CHURCH STREET SANTA MARIA,CA93454 95-3818027	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(98)MARK TWAIN MEDICAL CENTER 768 MOUNTAIN RANCH ROAD SAN ANDREAS,CA95249 68-0127677	HOSPITAL	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(99)MEMORIAL HEALTH CARE SYSTEM FOUNDATION INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-1839548	FUNDRAISING FOUNDATION	TN	501(C)(3)	LINE 7	MHCS		No
(100)MEMORIAL HEALTH CARE SYSTEM INC 2525 DE SALES AVE CHATTANOOGA,TN37404 62-0532345	HOSPITAL	TN	501(C)(3)	LINE 3	CSH		No
(101)MEMORIAL HEALTH PARTNERS FOUNDATION INC 5600 BRAINERD RD STE 500 CHATTANOOGA,TN37411 03-0417049	HEALTHCARE	TN	501(C)(3)	LINE 10	MHCS		No
(102)MEMORIAL HEALTH SYSTEM OF EAST TEXAS PO BOX 1447 LUFKIN,TX75902 75-0755367	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(103)MEMORIAL MEDICAL CENTER - LIVINGSTON PO BOX 1447 LUFKIN,TX75902 76-0436439	HOSPITAL	TX	501(C)(3)	LINE 3	MHSET		No
(104)MEMORIAL MEDICAL CENTER - SAN AUGUSTINE PO BOX 1447 LUFKIN,TX75902 75-2663904	HOSPITAL	TX	501(C)(3)	LINE 3	MHSET		No
(105)MEMORIAL MULTISPECIALTY ASSOCIATES 1201 FRANK AVE LUFKIN,TX95904 75-2721155	PHYSICIANS	TX	501(C)(3)	LINE 12A, I	MHSET		No
(106)MEMORIAL SPECIALTY HOSPITAL PO BOX 1447 LUFKIN,TX95902 75-2492741	HOSPITAL	TX	501(C)(3)	LINE 3	MHSET		No
(107)MERCY AUXILIARY OF CENTRAL IOWA 1111 6TH AVE DES MOINES,IA50314 42-6076069	AUXILIARY	IA	501(C)(3)	LINE 12A, I	MF-DM IA		No
(108)MERCY CLINICS INC 1111 6TH AVE DES MOINES,IA50314 42-1193699	PHYSICIANS	IA	501(C)(3)	LINE 10	CHI-IA CORP		No
(109)MERCY COLLEGE OF HEALTH SCIENCES 1111 6TH AVE DES MOINES,IA50314 42-1511682	EDUCATION	IA	501(C)(3)	LINE 2	CHI-IA CORP		No
(110)MERCY FOUNDATION BAKERSFIELD PO BOX 119 BAKERSFIELD,CA93302 77-0201321	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(111)MERCY FOUNDATION INC 2700 STEWART PKWY ROSEBURG,OR97471 93-6088946	FUNDRAISING FOUNDATION	OR	501(C)(3)	LINE 7	MMC		No
(112)MERCY FOUNDATION NORTH 2625 EDITH AVENUE SUITE E REDDING,CA96001 94-3136799	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	N/A		No
(113)MERCY FOUNDATION OF DES MOINES IA 1111 6TH AVE DES MOINES,IA50314 23-7358794	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 7	CHI-IA CORP		No
(114)MERCY FOUNDATION SACRAMENTO 3400 DATA DRIVE 3RD FLR RANCHO CORDOVA,CA95670 23-7072762	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	N/A		No
(115)MERCY HEALTH CARE FOUNDATION PO BOX 368 CORNING,IA50841 42-1461064	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 12A, I	AHMH-CORNING		No
(116)MERCY HEALTHCARE FOUNDATION 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0435338	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	MHVC		No
(117)MERCY HOSPITAL FOUNDATION COUNCIL BLUFFS 800 MERCY DR COUNCIL BLUFFS,IA51503 42-1178204	FUNDRAISING FOUNDATION	IA	501(C)(3)	LINE 12A, I	AHBMHS		No
(118)MERCY HOSPITAL OF DEVILS LAKE 1031 7TH ST NE DEVILS LAKE,ND58301 45-0227012	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(119)MERCY HOSPITAL OF DEVILS LAKE FOUNDATION 1031 7TH ST NE DEVILS LAKE,ND58301 35-2367360	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 7	MHDL		No
(120)MERCY HOSPITAL OF VALLEY CITY 570 CHAUTAUQUA BLVD VALLEY CITY,ND58072 45-0226553	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(121)MERCY MCMAHON TERRACE 3865 J STREET SACRAMENTO,CA95816 68-0117340	SENIOR CITIZEN'S HOUSING/RETIREMENT COMMUNITIES	CA	501(C)(3)	LINE 10	DIGNITY HEALTH		No
(122)MERCY MEDICAL CENTER 1301 15TH AVE WEST WILLISTON,ND58801 45-0231183	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(123)MERCY MEDICAL CENTER - CENTERVILLE ONE ST JOSEPHS DRIVE CENTERVILLE,IA52544 42-0680308	HOSPITAL	IA	501(C)(3)	LINE 3	CHI-IA CORP		No
(124)MERCY MEDICAL CENTER - NEWTON DBA SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON,IA50314 42-1470935	HOSPITAL	IA	501(C)(3)	LINE 3	CHI-IA CORP		No
(125)MERCY MEDICAL CENTER INC 2700 STEWART PKWY ROSEBURG,OR97471 93-0386868	HOSPITAL	OR	501(C)(3)	LINE 3	CSH		No
(126)MERCY MEDICAL CENTER MERCED FOUNDATION 301 E 13TH STREET MERCED,CA95340 77-0035928	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(127)MERCY MEDICAL FOUNDATION 1301 15TH AVE WEST WILLISTON,ND58801 45-0381803	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	MMC		No
(128)NEBRASKA HEART HOSPITAL 7500 S 91ST ST LINCOLN,NE68526 39-2031968	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(129)NORTHLAND HEALTHCARE ALLIANCE 2223 EAST ROSSER AVENUE BISMARCK,ND58501 91-1845296	MANAGEMENT	ND	501(C)(3)	LINE 7	NCHA		No
(130)NORTHRIDGE HOSPITAL FOUNDATION 18300 ROSCOE BLVD NORTHRIDGE,CA91328 23-7444901	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY COMMUNITY CARE		No
(131)OAKES COMMUNITY HOSPITAL 1200 N 7TH ST OAKES,ND58474 45-0231675	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(132)OAKES COMMUNITY HOSPITAL FOUNDATION 1200 N 7TH ST OAKES,ND58474 71-0966606	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	OCH		No
(133)PACIFIC CENTRAL COAST HEALTH CENTERS 1400 E CHURCH STREET SANTA MARIA,CA93454 77-0447575	CLINIC	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(134)PINEYWOODS MEDICAL DEVELOPMENT CORP PO BOX 1447 LUFKIN,TX75902 75-2493116	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	MHSET		No
(135)PROVIDENCE CARE CENTER 2025 HAYES AVENUE SANDUSKY,OH44870 34-1658625	HEALTHCARE	OH	501(C)(3)	LINE 10	CHILC		No
(136)PROVIDENCE CARE CENTERS 2025 HAYES AVENUE SANDUSKY,OH44870 34-1826099	HOLDING CO	OH	501(C)(3)	LINE 12B, II	CHILC		No
(137)PROVIDENCE RESIDENTIAL COMMUNITY CORPORATION 5055 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1896807	LIVING COMM	OH	501(C)(3)	LINE 10	CHILC		No
(138)PUEBLO STEPUP 1925 E ORMAN AVE STE G52 PUEBLO,CO81004 84-1234295	COMMUNITY	CO	501(C)(3)	LINE 7	CHIC		No
(139)REGIONAL HOSPITAL FOR RESPIRATORY AND COMPLEX CARE 16251 SYLVESTER ROAD SW BURIEN,WA98166 91-1170040	HOSPITAL	WA	501(C)(3)	LINE 3	FHS		No
(140)SAINT CLARE'S COMMUNITY CARE INC 25 POCONO RD DENVILLE,NJ07834 22-2876836	HEALTHCARE	NJ	501(C)(3)	LINE 10	SCHS		No
(141)SAINT CLARE'S HEALTH SERVICES INC 25 POCONO RD DENVILLE,NJ07834 22-3639733	MANAGEMENT	NJ	501(C)(3)	LINE 10	CSH		No
(142)SAINT CLARE'S HOSPITAL INC 25 POCONO RD DENVILLE,NJ07834 22-3319886	HEALTHCARE	NJ	501(C)(3)	LINE 3	SCHS		No
(143)SAINT ELIZABETH FOUNDATION 555 S 70TH ST LINCOLN,NE68510 47-0625523	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	SERMC		No
(144)SAINT ELIZABETH HEALTH SERVICES 555 S 70TH ST LINCOLN,NE68510 36-3233120	HOSPITAL	NE	501(C)(3)	LINE 3	SERMC		No
(145)SAINT ELIZABETH REGIONAL MEDICAL CENTER 555 S 70TH ST LINCOLN,NE68510 47-0379836	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(146)SAINT FRANCIS MEDICAL CENTER 2620 W FAIDLEY GRAND ISLAND,NE68803 47-0376601	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(147)SAINT FRANCIS MEDICAL CENTER FOUNDATION PO BOX 9804 GRAND ISLAND,NE68802 47-0630267	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	SFMC		No
(148)SAINT FRANCIS MEMORIAL HOSPITAL 900 HYDE STREET SAN FRANCISCO,CA94109 94-1156295	HOSPITAL	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(149)SAINT JOSEPH BEREA HOSPITAL FOUNDATION INC 305 ESTILL ST BEREA,KY40403 26-0152877	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 7	SJHS		No
(150)SAINT JOSEPH HEALTH SYSTEM INC 200 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 61-1334601	HOSPITAL	KY	501(C)(3)	LINE 3	KOH		No
(151)SAINT JOSEPH HOSPITAL FOUNDATION INC 701 BOB OLINK DR 200 LEXINGTON,KY40504 61-1159649	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 12A, I	SJHS		No
(152)SAINT JOSEPH LONDON FOUNDATION INC 1001 SAINT JOSEPH LANE LONDON,KY40741 26-0438748	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 7	SJHS		No
(153)SAINT JOSEPH MOUNT STERLING FOUNDATION INC 225 FALCON DR MOUNT STERLING,KY40353 27-2884584	FUNDRAISING FOUNDATION	KY	501(C)(3)	LINE 7	SJHS		No
(154)SAINT JOSEPH'S HOSPITAL FOUNDATION 2500 FAIRWAY STREET DICKINSON,ND58601 36-3418207	FUNDRAISING FOUNDATION	ND	501(C)(3)	LINE 12A, I	SJHHC		No
(155)SAN GABRIEL VALLEY MEDICAL CENTER FOUNDATION 438 WEST LAS TUNAS DRIVE SAN GABRIEL,CA91776 95-3430341	INACTIVE	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(156)SCHUYLER MEMORIAL HOSPITAL FOUNDATION INC 104 W 17TH ST SCHUYLER,NE68661 36-3630014	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 12A, I	AHMHS		No
(157)SEQUOIA HOSPITAL FOUNDATION 170 ALAMEDA DE LAS PULGAS REDWOOD CITY,CA94062 94-2909990	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12D, III-O	N/A		No
(158)SET OF COLORADO SPRINGS INC 9100 E MINERAL CIRCLE CENTENNIAL,CO80112 84-1183335	SENIOR CENTER SERVICES	CO	501(C)(3)	LINE 7	CHIC		No
(159)SIERRA NEVADA MEMORIAL-MINERS HOSPITAL 155 GLASSON WAY GRASS VALLEY,CA95945 94-1439787	HOSPITAL	CA	501(C)(3)	LINE 3	DIGNITY COMMUNITY CARE		No
(160)SJRMC JOPLIN MISSOURI 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 44-0545809	HOSPITAL	MO	501(C)(3)	LINE 3	CSH		No
(161)ST ALEXIUS MEDICAL CENTER 900 EAST BROADWAY AVENUE BISMARCK,ND58501 45-0226711	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(162)ST ANTHONY HOSPITAL 2801 ST ANTHONY WAY PENDLETON,OR97801 93-0391614	HOSPITAL	OR	501(C)(3)	LINE 3	CSH		No
(163)ST ANTHONY HOSPITAL FOUNDATION 2801 ST ANTHONY WAY PENDLETON,OR97801 93-0992727	FUNDRAISING FOUNDATION	OR	501(C)(3)	LINE 12A, I	SAH		No
(164)ST ANTHONY'S HOSPITAL ASSOCIATION FOUR HOSPITAL DR MORRILTON,AR72110 71-0245507	HOSPITAL	AR	501(C)(3)	LINE 3	SVIMC		No
(165)ST CATHERINE HOSPITAL 401 EAST SPRUCE ST GARDEN CITY,KS67846 48-0543721	HOSPITAL	KS	501(C)(3)	LINE 3	CSH		No
(166)ST CATHERINE HOSPITAL DEVELOPMENT FOUNDATION 401 EAST SPRUCE ST GARDEN CITY,KS67846 20-0598702	FUNDRAISING FOUNDATION	KS	501(C)(3)	LINE 12A, I	SCH		No
(167)ST CLARE COMMONS 12469 FIVE POINT ROAD TOLEDO,OH43551 27-0163752	LIVING COMM	OH	501(C)(3)	LINE 10	CHILC		No
(168)ST DOMINIC OF ONTARIO OREGON 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 93-0433692	HEALTHCARE	OR	501(C)(4)	N/A	CSH		No
(169)ST FRANCIS FOUNDATION OF SANTA BARBARA 2323 DE LA VINA ST SUITE 104 SANTA BARBARA,CA93105 23-7137119	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(170)ST FRANCIS HOME 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0729978	LONG-TERM CARE	MN	501(C)(3)	LINE 10	CSH		No
(171)ST FRANCIS HOSPITAL SUPPORT CORPORATION 601 E MICHELTORENA STREET SANTA BARBARA,CA93103 77-0022302	INACTIVE	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(172)ST FRANCIS LIFE CARE CORPORATION 19 POCONO RD DENVILLE,NJ07834 22-2536017	ELDERLY CARE	NJ	501(C)(3)	LINE 8	SCHS		No
(173)ST FRANCIS MEDICAL CENTER 2400 ST FRANCIS DR BRECKENRIDGE,MN56520 41-0695598	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(174)ST JOHNS HEALTHCARE FOUNDATION 1600 NORTH ROSE AVENUE OXNARD,CA93030 20-2865781	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(175)ST JOSEPH FOUNDATION OF BRYAN TEXAS 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2351158	FUNDRAISING FOUNDATION	TX	501(C)(3)	LINE 12B, II	SJSC		No
(176)ST JOSEPH MANOR 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2847594	HEALTHCARE	TX	501(C)(3)	LINE 10	SJSC		No
(177)ST JOSEPH MEDICAL CENTER INC 201 INTERNATIONAL CIRCLE STE 212 HUNT VALLEY,MD21030 52-0591461	HOSPITAL	MD	501(C)(3)	LINE 3	CSH		No
(178)ST JOSEPH PHYSICIAN ASSOCIATES 2801 FRANCISCAN DRIVE BRYAN,TX77802 20-3159302	PHYSICIANS	TX	501(C)(3)	LINE 3	SJSC		No
(179)ST JOSEPH PHYSICIAN ENTERPRISE INC 201 INTERNATIONAL CIRCLE STE 212 HUNT VALLEY,MD21030 52-1311775	PHYSICIANS	MD	501(C)(3)	LINE 12A, I	SJMC		No
(180)ST JOSEPH REGIONAL HEALTH CENTER 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-1282696	HOSPITAL	TX	501(C)(3)	LINE 3	SJSC		No
(181)ST JOSEPH REGIONAL HEALTH PARTNERS 2801 FRANCISCAN DRIVE BRYAN,TX77802 45-4088170	HOSPITAL	TX	501(C)(3)	LINE 3	SJSC		No
(182)ST JOSEPH REGIONAL HEALTH PARTNERS ACO 2801 FRANCISCAN DRIVE BRYAN,TX77802 46-3265423	HEALTHCARE	TX	501(C)(3)	LINE 10	SJSC		No
(183)ST JOSEPH SERVICES CORPORATION 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2455161	MANAGEMENT	TX	501(C)(3)	LINE 12A, I	SLHS		No
(184)ST JOSEPHS FOUNDATION 350 WEST THOMAS ROAD PHOENIX,AZ85013 94-2941245	FUNDRAISING FOUNDATION	AZ	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(185)ST JOSEPHS FOUNDATION OF SAN JOAQUIN 1800 N CALIFORNIA STREET STOCKTON,CA95204 51-0432777	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(186)ST JOSEPH'S AREA HEALTH SERVICES 600 PLEASANT AVE PARK RAPIDS,MN56470 41-0695603	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(187)ST JOSEPH'S HOSPITAL AND HEALTH CENTER 2500 FAIRWAY ST DICKINSON,ND58601 45-0226429	HOSPITAL	ND	501(C)(3)	LINE 3	CSH		No
(188)ST LEONARD 8100 CLYO ROAD CENTERVILLE,OH45458 34-1940863	LIVING COMM	OH	501(C)(3)	LINE 10	CHILC		No
(189)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - PMC 6624 FANNIN ST STE 2505 HOUSTON,TX77030 27-3733278	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(190)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - SUGAR LAND 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-1947374	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(191)ST LUKE'S COMMUNITY DEVELOPMENT CORPORATION - THE WOODLANDS 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-0335902	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(192)ST LUKE'S COMMUNITY HEALTH SERVICES 6624 FANNIN ST STE 1100 HOUSTON,TX77030 76-0536234	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(193)ST LUKE'S FOUNDATION 1213 HERMANN DRIVE STE 855 HOUSTON,TX77004 45-3811485	FUNDRAISING FOUNDATION	TX	501(C)(3)	LINE 7	SLHS		No
(194)ST LUKE'S HEALTH SYSTEM CORPORATION PO BOX 20269 HOUSTON,TX77225 76-0536232	MANAGEMENT	TX	501(C)(3)	LINE 12A, I	CSH		No
(195)ST LUKE'S HOSPITAL AT THE VINTAGE 6624 FANNIN ST STE 2505 HOUSTON,TX77030 26-3734606	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(196)ST LUKE'S PROPERTIES CORPORATION 1213 HERMANN DRIVE STE 855 HOUSTON,TX77004 76-0531716	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	SLHS		No
(197)ST LUKE'S SUGAR LAND PROPERTIES CORPORATION 6624 FANNIN ST STE 2505 HOUSTON,TX77030 45-4120549	PROPERTY MGMT	TX	501(C)(3)	LINE 12A, I	SLCDC-SL		No
(198)ST MARY MEDICAL CENTER FOUNDATION 1050 LINDEN AVENUE LONG BEACH,CA90813 23-7153876	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(199)ST MARY PROFESSIONAL BUILDING INC 1050 LINDEN AVENUE LONG BEACH,CA90813 23-7373088	INACTIVE	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(200)ST MARYS MEDICAL CENTER FOUNDATION 450 STANYAN STREET SAN FRANCISCO,CA94117 94-3336143	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(201)ST MARY'S COMMUNITY HOSPITAL 1301 GRUNDMAN BOULEVARD NEBRASKA CITY,NE68410 47-0443636	HOSPITAL	NE	501(C)(3)	LINE 3	CHI NEBRASKA		No
(202)ST MARY'S HOSPITAL FOUNDATION 1314 3RD AVE NEBRASKA CITY,NE68410 47-0707604	FUNDRAISING FOUNDATION	NE	501(C)(3)	LINE 7	SMCH		No
(203)ST ROSE DOMINICAN HEALTH FOUNDATION 3001 ST ROSE PARKWAY HENDERSON,NV89052 88-0349432	FUNDRAISING FOUNDATION	NV	501(C)(3)	LINE 12A, I	DIGNITY HEALTH		No
(204)ST VINCENT FOUNDATION TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 51-0169537	FUNDRAISING FOUNDATION	AR	501(C)(3)	LINE 12A, I	SVIMC		No
(205)ST VINCENT INFIRMARY MEDICAL CENTER TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0236917	HOSPITAL	AR	501(C)(3)	LINE 3	CSH		No
(206)ST VINCENT MEDICAL GROUP TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0830696	HEALTHCARE	AR	501(C)(3)	LINE 10	SVIMC		No
(207)SYLVANIA FRANCISCAN HEALTH 1715 INDIAN WOOD CIR 200 MAUMEE,OH43537 34-1412964	HEALTHCARE	OH	501(C)(3)	LINE 12A, I	CSH		No
(208)SYLVANIA FRANCISCAN HEALTH FOUNDATION 1715 INDIAN WOOD CIR 200 MAUMEE,OH43537 45-5357161	FUNDRAISING FOUNDATION	OH	501(C)(3)	LINE 12A, I	SFH		No
(209)THE COMMONS OF PROVIDENCE 5000 PROVIDENCE DRIVE SANDUSKY,OH44870 34-1826097	ASSIST LIVING	OH	501(C)(3)	LINE 10	CHILC		No
(210)THE COMMUNITY HOSPITAL OF BRAZOSPORT 100 MEDICAL DRIVE LAKE JACKSON,TX77566 74-1385192	HOSPITAL	TX	501(C)(3)	LINE 3	SLHS		No
(211)THE GOOD SAMARITAN HOSPITAL OF CINCINNATI OH 625 EDEN PARK DRIVE 7TH FLOOR CINCINNATI,OH45202 31-0537486	HOSPITAL	OH	501(C)(3)	LINE 3	CSH		No
(212)THE PHYSICIAN NETWORK 2000 Q ST STE 500 LINCOLN,NE68503 47-0780857	PHYSICIANS	NE	501(C)(3)	LINE 12A, I	CHI NEBRASKA		No
(213)TOTAL HEALTHCARE 9100 E MINERAL CIRCLE CENTENNIAL,CO80112 84-0927232	HOSPITAL	CO	501(C)(3)	LINE 3	CHIC		No
(214)TRINITY HEALTH FOUNDATION 380 SUMMIT AVENUE STEUBENVILLE,OH43952 31-1329423	FUNDRAISING FOUNDATION	OH	501(C)(3)	LINE 12A, I	THS		No
(215)TRINITY HEALTH SYSTEM 380 SUMMIT AVENUE STEUBENVILLE,OH43952 34-1818681	HEALTHCARE	OH	501(C)(3)	LINE 12A, I	N/A		No
(216)TRINITY HOSPITAL TWIN CITY 819 NORTH FIRST STREET DENNISON,OH44621 27-5401105	HOSPITAL	OH	501(C)(3)	LINE 3	THS		No
(217)TRI-STATE HEALTH SERVICES INC ONE ROSS PARK BLVD STEUBENVILLE,OH43952 34-1522484	ASSIST LIVING	OH	501(C)(3)	LINE 7	THS		No
(218)UNITY FAMILY HEALTHCARE 815 SE 2ND ST LITTLE FALLS,MN56345 41-0721642	HOSPITAL	MN	501(C)(3)	LINE 3	CSH		No
(219)VILLA NAZARETH INC 801 PAGE DR FARGO,ND58103 45-0226714	LONG-TERM CARE	ND	501(C)(3)	LINE 10	CSH		No
(220)VISITING NURSE ASSOCIATION OF ST CLARE'S INC 191 WOODPORT RD SPARTA,NJ07871 22-1768334	HOME HEALTH	NJ	501(C)(3)	LINE 10	SCHS		No
(221)WOODLAND MEMORIAL HOSPITAL FOUNDATION 1321 COTTONWOOD STREET 305 WOODLAND,CA95695 94-6167964	FUNDRAISING FOUNDATION	CA	501(C)(3)	LINE 7	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) AMERICAN MERCY HOME CARE LLC 1700 EDISON DR MILFORD,OH45150 83-0486150	HOME HEALTH	OH	N/A	N/A				No			No
(2) ARIZONA CARE NETWORK - NEXT LLC 350 W THOMAS RD PHOENIX,AZ85018 47-4696671	CARE NETWORK	AZ	N/A	N/A				No			No
(3) ARIZONA CARE NETWORK LLC 350 W THOMAS RD PHOENIX,AZ85013 45-4494682	CARE NETWORK	AZ	N/A	N/A				No			No
(4) AUDUBON LAND COMPANY LLC 630 SOUTHPOINTE COURT 200 COLORADO SPRINGS,CO80906 84-1513085	REAL ESTATE	CO	N/A	N/A				No			No
(5) AVON EMERGENCY AND URGENT CARE CENTER LLC 9100 E MINERAL CIRCLE CENTENNIAL,CO80112 81-1727282	HEALTHCARE SRVC	CO	N/A	N/A				No			No
(6) BAYLOR CHI ST LUKES HEALTH SERVICES LLC 6624 FANNIN ST STE 1100 HOUSTON,TX77030 47-2079184	HEALTHCARE SRVC	TX	N/A	N/A				No			No
(7) BERGAN MERCY SURGERY CENTER LLC 7710 MERCY RD STE 200 OMAHA,NE68124 20-8671994	AMBUL SURG CTR	NE	N/A	N/A				No			No
(8) BERYWOOD OFFICE PROPERTIES LLC 2501 CITICO AVENUE CHATTANOGA,TN37404 62-1875199	PHYS OFFICE	TN	N/A	N/A				No			No
(9) BIOLIFE DIGNITY HEALTH INTERNATIONAL LTD 709 WING ON PLAZA 62 MODY ROAD TST HONG KONG CH	HEALTH SERVICES	CH	N/A	N/A				No			No
(10) BLUEGRASS REGIONAL IMAGING CENTER 1218 SOUTH BROADWAY STE 310 LEXINGTON,KY40504 61-1386736	DIAGNOSTIC IMAGING	KY	N/A	N/A				No			No
(11) CBCC OUTSMARTING CANCER LLC 6501 TRUXTUN AVENUE BAKERSFIELD,CA93309 46-1602286	RADIATION / ONCOLOGY	CA	N/A	N/A				No			No
(12) CENTRAL NEBRASKA REHABILITATION SERVICES LLC 3004 W FAIDLEY AVENUE GRAND ISLAND,NE68803 81-0653461	PHYSICAL THERAPY	NE	N/A	N/A				No			No
(13) CENTURA-SCA HOLDINGS LLC 569 BROOK VILLAGE STE 901 BIRMINGHAM,AL35209 47-4823023	OP SURGERY CENTER	AL	N/A	N/A				No			No
(14) CHI OPERATING INVESTMENT PROGRAM LP 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 47-0727942	INVESTMENTS	CO	N/A	N/A				No			No
(15) CHICAMSURG SURGERY CENTERS LLC 1A BURTON HILLS BLVD NASHVILLE,TN37215 46-5683027	SURGERY CENTER	CO	N/A	N/A				No			No
(16) COLORADO SPRINGS CK LEASING LLC 630 SOUTHPOINTE COURT 200 COLORADO SPRINGS,CO80906 26-2982714	REAL ESTATE	CO	N/A	N/A				No			No
(17) COMMUNITY MERCY HOME CARE SERVICES OF SPRINGFIELD LLC 1700 EDISON DR MILFORD,OH45150 31-1746556	HOME HEALTH	OH	N/A	N/A				No			No
(18) DE JV LLC 8686 NEW TRAILS DRIVE THE WOODLANDS,TX77381 32-0496548	EMERGENCY CARE	NV	N/A	N/A				No			No
(19) DHHP SURGERY CENTERS LLC 1513 S GRAND AVENUE STE 350 LOS ANGELES,CA90015 83-1847466	SURGERY	CA	N/A	N/A				No			No
(20) DHRT HOLDINGS LLC 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 35-2484591	HOLDING COMPANY	DE	N/A	N/A				No			No
(21) DIGNITY- GOHEALTH URGENT CARE MANAGEMENT LLC 5555 GLENRIDGE CONNECTOR SUITE 700 ATLANTA,GA30342 35-2548698	MANAGEMENT SERVICES	DE	N/A	N/A				No			No
(22) DIGNITY HEALTH AT HOME LLC 1700 EDISON DR MILFORD,OH45150 82-4674115	HEALTHCARE SRVC	DE	N/A	N/A				No			No
(23) DIGNITY HEALTH SPECIALTY PHARMACY LLC 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 32-0589462	SPECIALTY PHARMACY SERVICES	DE	N/A	N/A				No			No
(24) DIGNITY HOME RECOVERY CARE LLC 49 MUSIC SQUARE WEST SUITE 401 NASHVILLE,TN37203 83-2832522	HOME RECOVERY PROGRAM	DE	N/A	N/A				No			No
(25) DIGNITYUSP LAS VEGAS SURGERY CENTERS LLC 15305 DALLAS PARKWAY SUITE 1600 LB ADDISON,TX75001 20-2999237	SURGERY	TX	N/A	N/A				No			No
(26) DIGNITYUSP NORCAL SURGERY CENTERS LLC 15305 DALLAS PARKWAY SUITE 1600 LB ADDISON,TX75001 20-2468509	SURGERY	TX	N/A	N/A				No			No
(27) DIGNITYUSP PHOENIX SURGERY CENTERS LLC 15305 DALLAS PARKWAY SUITE 1600 LB ADDISON,TX75001 13-4248908	SURGERY	TX	N/A	N/A				No			No
(28) DIGNITYUSPJOHN MUIR EAST BAY SURG CTRS LLC 15305 DALLAS PARKWAY SUITE 1600 LB ADDISON,TX75001 35-2584991	SURGERY	TX	N/A	N/A				No			No
(29) DIGNITY-ABRAZO HEALTH NETWORK LLC 3030 N CENTRAL AVENUE SUITE 1402 PHOENIX,AZ85012 46-5477985	MANAGEMENT SERVICES	AZ	N/A	N/A				No			No
(30) DOMINICAN MAGNETIC RESONANCE IMAGING CENTER 1545 SOQUEL DRIVE SANTA CRUZ,CA94065 77-0095477	IMAGING CENTER	CA	N/A	N/A				No			No
(31) ECCS ACQUISITION COMPANY LLC 2940 NORTH CIRCLE DRIVE COLORADO SPRINGS,CO80909 35-2656413	AMBUL SURG CTR	CO	N/A	N/A				No			No
(32) FOLSOM SIERRA ENDOSCOPY CENTER LP 1650 CREEKSIDE DRIVE 1600 FOLSOM,CA95630 68-0482416	ENDOSCOPY	CA	N/A	N/A				No			No
(33) FRANCISCAN MEDICAL PAVILION BONNEY LAKE LLC 6622 WOLLOCHET DR NW GIG HARBOR,WA98335 46-3494108	REAL ESTATE	WA	N/A	N/A				No			No
(34) FRANCISCAN SPECIALTY CARE LLC 680 SOUTH FOURTH STREET LOUISVILLE,KY40202 81-3725123	HEALTHCARE SRVC	WA	N/A	N/A				No			No
(35) GOOD SAMARITAN HOME CARE SERVICES OF VINCENNE IN LLC 1700 EDISON DR MILFORD,OH45150 20-1792869	HOME HEALTH	OH	N/A	N/A				No			No
(36) HC SL VINTAGE I LLC 18000 W SARAH LANE STE 250 BROOKFIELD,WI53045 27-0453767	PROPERTY HOLDING	WI	N/A	N/A				No			No
(37) HEALTHCARE SUPPORT SERVICES LLC PO BOX 9804 GRAND ISLAND,NE68802 72-1546196	LAUNDRY	NE	N/A	N/A				No			No
(38) HEARTLAND ONCOLOGY LLC 2337 E CRAWFORD ST SALINA,KS67401 46-4265403	ONCOLOGY	KS	N/A	N/A				No			No
(39) LAKESIDE AMBULATORY SURGICAL CENTER LLC 17031 LAKESIDE HILLS DR OMAHA,NE68130 20-4267902	AMBUL SURG CTR	NE	N/A	N/A				No			No
(40) LAKESIDE ENDOSCOPY CENTER LLC 17001 LAKESIDE HILLS PLZ STE 201 OMAHA,NE68130 20-5544496	ENDOSCOPY SRVC	NE	N/A	N/A				No			No
(41) LINCOLN CK LEASING LLC 555 SOUTH 70TH STREET LINCOLN,NE68510 26-2496856	REAL ESTATE	NE	N/A	N/A				No			No
(42) MEMORIAL MEDICAL PLAZA 3838 SAN DIMAS SUITE B 201 BAKERSFIELD,CA93301 36-4510880	REAL ESTATE	CA	N/A	N/A				No			No
(43) MERCY DAVIS CANCER CENTER MANAGEMENT CO LLC 2740 M STREET MERCED,CA95340 94-3358445	MANAGEMENT OF CANCER CENTER	CA	N/A	N/A				No			No
(44) MERCY REHABILITATION HOSPITAL LLC 680 SOUTH FOURTH STREET LOUISVILLE,KY40202 81-4437201	HEALTHCARE SRVC	TX	N/A	N/A				No			No
(45) MILITARY ROAD PROPERTIES LLC 181 S 333RD STREET STE 250 FEDERAL WAY,WA98003 91-2067879	REAL ESTATE	WA	N/A	N/A				No			No
(46) NEBRASKA SPINE HOSPITAL LLC 6901 N 72ND ST STE 20300 OMAHA,NE68122 27-0263191	SPINE HOSPITAL	NE	N/A	N/A				No			No
(47) NICU OPERATING CO OF SANTA CRUZ LLC 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 46-0502935	NEONATAL HEALTHCARE	CA	N/A	N/A				No			No
(48) NORTH RIVER SURGERY CENTER LLC 2209 WILDWOOD AVE SHERWOOD,AR72120 71-0799771	AMBUL SURG CTR	AR	N/A	N/A				No			No
(49) NORTHERN PLAINS LABORATORY LLC 401 N 9 STREET BISMARK,ND58501 84-1641341	DIAGNOSTIC SERVICES	ND	N/A	N/A				No			No
(50) NSC CHANNEL ISLANDS LLC 3000 RIVERCHASE GALLERIA SUITE 500 BIRMINGHAM,AL35244 77-0418197	AMBULATORY SURGICAL CENTER	CA	N/A	N/A				No			No
(51) OMG ARIZONA LLC 130 SUTTER STREET 2ND FLR SAN FRANCISCO,CA94104 47-1708588	MEDICAL OFFICE	AZ	N/A	N/A				No			No
(52) ORTHOCOLORADO LLC 11650 WEST 2ND PLACE LAKEWOOD,CO80228 37-1577105	ORTHO HOSPITAL	CO	N/A	N/A				No			No
(53) PARK RAPIDS AREA HEALTH CARE 600 PLEASANT AVENUE S PARK RAPIDS,MN56470 20-4926259	HEALTHCARE SRVC	MN	N/A	N/A				No			No
(54) PASADENA URGENCY CENTER LLC 4600 E SAM HOUSTON PKWY SOUTH PASADENA,TX77505 81-2482854	URGENT CARE	TX	N/A	N/A				No			No
(55) PATIENT TRANSPORT SERVICES OF COLUMBUS INC 1700 EDISON DR MILFORD,OH45150 26-4601285	AMBULANCE	OH	N/A	N/A				No			No
(56) PENINSULA RADIATION ONCOLOGY LLC 314 MLK JR WAY STE 11 TACOMA,WA98405 87-0808610	HEALTHCARE SRVC	WA	N/A	N/A				No			No
(57) PENRAD IMAGING LLC 1390 KELLY JOHNSON BLVD COLORADO SPRINGS,CO80920 84-1072619	MEDICAL IMAGING	CO	N/A	N/A				No			No
(58) PERFORMANCE MEDICAL EQUIPMENT & RESPIRATORY SVSC LLC 19625 62ND AVENUE SOUTH STE 101 KENT,WA98032 45-2901632	HOLDING COMPANY	WA	N/A	N/A				No			No
(59) PLAZA SURGERY CENTER LP 525 E PLAZA DRIVE SUITE 100 SANTA MARIA,CA93454 77-0573567	SURGERY	CA	N/A	N/A				No			No
(60) PMC HOSPITAL LLC 3100 MAIN ST STE 500 HOUSTON,TX77002 27-3280598	HOSPITAL	TX	N/A	N/A				No			No
(61) PRECISION MEDICINE ALLIANCE LLC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 35-2569159	DIAGNOSTIC SERVICES	CO	N/A	N/A				No			No
(62) PUEBLO AMBULATORY SURGERY CENTER LLC 25 MONTEBELLO RD PUEBLO,CO81003 62-1488737	SURGERY CENTER	CO	N/A	N/A				No			No
(63) RADIATION ONCOLOGY CENTERS OF VENTURA COUNTY 1700 N ROSE AVENUE SUITE 120 OXNARD,CA93030 77-0191706	IMAGING	CA	N/A	N/A				No			No
(64) RBR MANAGEMENT LLC 91 CORPORATE PARK DRIVE SUITE 120 HENDERSON,NV89074 27-1466450	AMBULANCE	NV	N/A	N/A				No			No
(65) REID-ANC HOME CARE SERVICES LLC 1700 EDISON DR MILFORD,OH45150 37-1454747	HOME HEALTH	IN	N/A	N/A				No			No
(66) SAINT JOSEPH - SCA HOLDINGS LLC 1451 HARRODSBURG RD LEXINGTON,KY40503 45-3801157	OP SURGERY	DE	N/A	N/A				No			No
(67) SAINT JOSEPH-ANC HOME CARE SERVICES 1700 EDISON DR MILFORD,OH45150 26-3330545	HOME HEALTH	KY	N/A	N/A				No			No
(68) SANTA CRUZ COMPREHENSIVE IMAGING LLC 1661 SOQUEL DRIVE SUITE G SANTA CRUZ,CA95065 01-0550623	IMAGING	CA	N/A	N/A				No			No
(69) SANTA CRUZ LAND & BUILDING LP 1555 SOQUEL DRIVE SANTA CRUZ,CA95065 77-0285236	REAL ESTATE	CA	N/A	N/A				No			No
(70) SANTA CRUZ SURGERY CENTER LLC 3003 PAUL SWEET ROAD SANTA CRUZ,CA95065 77-0194916	SURGERY	CA	N/A	N/A				No			No
(71) SOUTHEASTERN HOME CARE LLC 1700 EDISON DR MILFORD,OH45150 27-1219638	HOME HEALTH	OH	N/A	N/A				No			No
(72) ST JOSEPH'S SURGERY CENTER LP 15305 DALLAS PARKWAY SUITE 1600 LB ADDISON,TX75001 20-1019390	SURGERY	TX	PORT CITY	RELATED	1,512,847	4,298,927		No		Yes		70.180 %
(73) ST ELIZABETH HOME CARE SERVICES LLC 1700 EDISON DR MILFORD,OH45150 26-1236191	HOME HEALTH	KY	N/A	N/A				No			No
(74) ST FRANCIS LAND COMPANY 5390 N ACADEMY BLVD STE 300 COLORADO SPRINGS,CO80918 26-3134100	REAL ESTATE	CO	N/A	N/A				No			No
(75) ST LUKE'S DIAGNOSTIC CATH LAB LLP 6624 FANNIN ST STE 800 HOUSTON,TX77030 71-0959365	DIAGNOSTICS	TX	N/A	N/A				No			No
(76) ST LUKE'S LAKESIDE HOSPITAL LLC 6624 FANNIN STE 2505 HOUSTON,TX77030 30-0427437	HOSPITAL	TX	N/A	N/A				No			No
(77) ST LUKE'S THE WOODLANDS SLEEP CENTER LLC 6624 FANNIN STE 800 HOUSTON,TX77030 46-2795726	DIAGNOSTICS	TX	N/A	N/A				No			No
(78) TEMPLETON SURGERY CENTER LLC 1310 LAS TABLAS ROAD SUITE 104 TEMPLETON,CA94365 20-2246616	SURGERY	CA	N/A	N/A				No			No
(79) THE MEDICAL PAVILION AT ST JOHN'S 1700 ROSE AVENUE OXNARD,CA93030 77-0332349	REAL ESTATE	CA	N/A	N/A				No			No
(80) THREE SPRING IMAGING LLC 1 MERCADO ST STE 200A DURANGO,CO81301 81-3571570	HEALTHCARE SRVC	CO	N/A	N/A				No			No
(81) VALLEY PHYSICIANS SURGERY CENTER AT NORTHRIDGE LLC 18330 ROSCOE BLVD NORTHRIDGE,CA91328 80-0864336	SURGERY	CA	N/A	N/A				No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ALEGENT HEALTHCREIGHTON ST JOSEPH MANAGED CARE SERVICES INC 12809 WEST DODGE RD OMAHA,NE68154 47-0802396	MANAGED CARE	NE	N/A	C				No
(2) ALL SAINTS INSURANCE COMPANY SPC LTD PO BOX 10073 APO GEORGETOWN,GRAND CAYMAN CJ 98-0556913	INSURANCE	CJ	N/A	C				No
(3) ALLIANCE HEALTH PROVIDERS OF BRAZOS VALLEY INC 2801 FRANCISCAN DRIVE BRYAN,TX77802 74-2466914	HEALTHCARE	TX	N/A	C				No
(4) ALTERNATIVE INSURANCE MANAGEMENT SERVICE INC 3900 OLYMPIC BLVD STE 400 ERLANGER,KY41018 84-1112049	MANAGEMENT SERVICES	CO	N/A	C				No
(5) AMERICAN NURSING CARE INC 1700 EDISON DR MILFORD,OH45150 31-1085414	HOME HEALTH	OH	N/A	C				No
(6) AMERIMED INC 1700 EDISON DR MILFORD,OH45150 31-1158699	HOME HEALTH	OH	N/A	C				No
(7) BC HOLDING COMPANY INC 1850 BLUEGRASS AVE LOUISVILLE,KY40215 31-1542851	FITNESS CLUB	KY	N/A	C				No
(8) BRAZOSPORT HEALTH ALLIANCE 1 WEST WAY COURT LAKE JACKSON,TX77566 76-0518376	HEALTH CARE	TX	N/A	C				No
(9) CADUCEUS MEDICAL ASSOCIATES INC 5600 BRAINERD ROAD STE 500 CHATTANOOGA,TN37411 62-1570736	HEALTHCARE	TN	N/A	C				No
(10) CAPTIVE MANAGEMENT INITIATIVES LTD PO BOX 10073 APO GEORGETOWN,GRAND CAYMAN CJ 98-0663022	CAPTIVE MANAGEMENT	CJ	N/A	C				No
(11) CATHOLIC HEALTH INITIATIVES CENTER FOR TRANSLATIONAL RESEARCH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-2269511	RESEARCH	CO	N/A	C				No
(12) CHI ST LUKE'S HEALTH - MEMORIAL CONDOMINIUM ASSOCIATION INC 1201 W FRANK AVE LUFKIN,TX75904 83-4184717	CONDO ASSOC	TX	N/A	C				No
(13) CLEARRIVER HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4495960	INSURANCE	TN	N/A	C				No
(14) COASTAL SURGICAL SPECIALISTS INC 921 OAK PARK BLVD SUITE 101 PISMO BEACH,CA93449 74-3000596	HEALTHCARE	CA	N/A	S				No
(15) COMCARE SERVICES INC 5570 DTC PARKWAY ENGLEWOOD,CO80111 84-0904813	INACTIVE	CO	N/A	C				No
(16) CONSOLIDATED HEALTH SERVICES 1700 EDISON DR MILFORD,OH45150 31-1378212	HOME HEALTH	OH	N/A	C				No
(17) DES MOINES MEDICAL CENTER INC 1111 6TH AVE DES MOINES,IA50314 42-0837382	REAL ESTATE	IA	N/A	C				No
(18) DIGNITY HEALTH HOLDING CORPORATION 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 46-0675371	HOLDING CO	NV	N/A	C				No
(19) DIGNITY HEALTH INSURANCE LTD PO BOX 1051 KY1-1102 GRAND CAYMAN ISLANDS,GRAND CAYMAN CJ 98-1065338	INSURANCE	CJ	N/A	C				No
(20) DIGNITY HEALTH PROVIDER RESOURCES INC 185 BERRY STREET SUITE 200 SAN FRANCISCO,CA94107 47-3366764	HEALTH PLAN	CA	N/A	C				No
(21) DIVERSIFIED HEALTH RESOURCES INC 100 MEDICAL DRIVE LAKE JACKSON,TX77566 76-0222679	HEALTH CARE	TX	N/A	C				No
(22) FIRST INITIATIVES INSURANCE LTD PO BOX 10073 APO GEORGETOWN,GRAND CAYMAN CJ 98-0203038	INSURANCE	CJ	N/A	C				No
(23) FRANCISCAN CITY URGENT CARE SVCS PS DBA CITY MD-FRANCISCAN UC 1345 AVE OF THE AMERICAS NEW YORK,NY10105 81-2174959	HEALTHCARE	NY	N/A	C				No
(24) FRANCISCAN SERVICES INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2487967	HEALTHCARE	CO	N/A	C				No
(25) GOOD SAMARITAN OUTREACH SERVICES PO BOX 1990 KEARNEY,NE68848 47-0659440	MEDICAL CLINIC	NE	N/A	C				No
(26) HARVESTPLAINS HEALTH OF IOWA 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 47-3451750	INSURANCE	WA	N/A	C				No
(27) HEALTH SERVICES OF THE PACIFIC CENTRAL COAST INC 1400 E CHURCH STREET SANTA MARIA,CA93454 77-0074057	HEALTHCARE	CA	N/A	C				No
(28) HEALTH SYSTEMS ENTERPRISES INC PO BOX 1990 KEARNEY,NE68848 47-0664558	MGMT	NE	N/A	C				No
(29) HEALTHCARE MGMT SERVICES ORGANIZATION INC 1149 MARKET ST TACOMA,WA98402 91-1865474	HEALTH ORG.	WA	N/A	C				No
(30) HEARTLANDPLAINS HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4368223	INSURANCE	NE	N/A	C				No
(31) HIGHLINE MEDICAL GROUP 1717 S J STREET TACOMA,WA98405 91-1407026	MEDICAL SERVICES	WA	N/A	C				No
(32) INTEGRATED MEDICAL SERVICES 9250 N 3RD STREET SUITE 4010 PHOENIX,AZ85020 86-0783428	MULTI-SPECIALTY PHYSICIANS GROUP	AZ	N/A	C				No
(33) KOMG-LOUISVILLE REGION INC 201 ABRAHAM FLEXNER WAY LOUISVILLE,KY40202 83-2481198	HEALTHCARE	KY	N/A	C				No
(34) MEDICAL OFFICE BUILDING HORIZONTAL PROPERTY REGIME INC 300 WERNER ST HOT SPRINGS,AR71913 71-0720429	REAL ESTATE	AR	N/A	C				No
(35) MEDQUEST 1301 15TH AVENUE WEST WILLISTON,ND58801 45-0392137	SALE OF DME	ND	N/A	C				No
(36) MEMORIAL CV SERVICE LINE MANAGEMENT COMPANY LLC 1201 W FRANK AVE LUFKIN,TX75904 46-3622849	HEATH CARE	TX	N/A	C				No
(37) MERCY PARK APARTMENTS LTD 1111 6TH AVE DES MOINES,IA50314 42-1202422	HOUSING	IA	N/A	C				No
(38) MERCY SERVICES CORP 2700 STEWART PARKWAY ROSEBURG,OR97471 93-0824308	RETAIL SALES	OR	N/A	C				No
(39) MHI CLINICAL SERVICES 1201 W FRANK AVE LUFKIN,TX75904 46-1967952	HEALTHCARE	TX	N/A	C				No
(40) MILLENNIUM SURGERY CENTER INC 9300 STOCKDALE HWY 200 BAKERSFIELD,CA93311 77-0513445	HEALTHCARE	CA	N/A	S				No
(41) MOUNTAIN MANAGEMENT SERVICES INC 6028 SHALLOWFORD RD CHATTANOOGA,TN37421 62-1570739	MGMT SVC ORG	TN	N/A	C				No
(42) NORTH CENTRAL HEALTH CARE ALLIANCE PO BOX 5538 BISMARK,ND58506 45-0439894	HEALTHCARE	ND	N/A	C				No
(43) PATIENT TRANSPORT SERVICES INC 1700 EDISON DR MILFORD,OH45150 31-1100798	HOME HEALTH	OH	N/A	C				No
(44) QUALCHOICE ADVANTAGE 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 47-3433912	INSURANCE	WA	N/A	C				No
(45) QUALCHOICE HEALTH PLAN SVS INC (FKA COLLABHEALTH PLAN SVS INC) 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-1224037	ADMIN SERVICES	CO	N/A	C				No
(46) QUALCHOICE HEALTH INC (FKA COLLABHEALTH MANAGED SOLUTIONS INC) 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-1222808	HOLDING CO	CO	N/A	C				No
(47) QUALCHOICE HOLDINGS INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 27-4075520	HOLDING CO	AR	N/A	C				No
(48) QUALCHOICE OF NEBRASKA 2401 S 73RD ST OMAHA,NE68124 81-0738827	INACTIVE	NE	N/A	C				No
(49) RIVERLINK HEALTH 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4380824	INSURANCE	OH	N/A	C				No
(50) RIVERLINK HEALTH OF KENTUCKY INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 46-4828332	INSURANCE	KY	N/A	C				No
(51) ROSS PARK PHARMACY INC 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1832654	PHARMACY	OH	N/A	C				No
(52) SAINT CLARE'S PRIMARY CARE INC 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 22-2441202	BILLING SERVICES	NJ	N/A	C				No
(53) SJH SERVICES CORPORATION 198 INVERNESS DRIVE WEST ENGLEWOOD,CO80112 23-2307408	HEALTHCARE	CO	N/A	C				No
(54) SJL PHYSICIAN MANAGEMENT SERVICES INC 424 LEWIS HARGETT CR STE 160 LEXINGTON,KY40503 27-0164198	MGMT	KY	N/A	C				No
(55) SOUNDPATH HEALTH INC 32129 WEYERHAEUSER WAY S STE 201 FEDERAL WAY,WA98001 42-1720801	INSURANCE	WA	N/A	C				No
(56) ST MARY HEALTH VENTURES INC 1050 LINDEN AVENUE LONG BEACH,CA90813 95-1912528	RETAIL PHARMACY	CA	N/A	C				No
(57) ST ANTHONY DEVELOPMENT COMPANY 1415 SOUTHGATE PENDLETON,OR97801 93-1216943	ATHLETIC CLUB	OR	N/A	C				No
(58) ST JOSEPH DEVELOPMENT COMPANY INC 1717 SOUTH J ST TACOMA,WA98405 91-1480569	RENTAL	WA	N/A	C				No
(59) ST LUKE'S HEALTH SYSTEM HOLDINGS INC 6624 FANNIN STE 800 HOUSTON,TX77030 76-0637138	HOLDING CO	TX	N/A	C				No
(60) ST VINCENT COMMUNITY HEALTH SERVICES INC TWO ST VINCENT CIRCLE LITTLE ROCK,AR72205 71-0710785	HEALTHCARE	AR	N/A	C				No
(61) STE HOLDINGS 12809 WEST DODGE RD OMAHA,NE68154 82-2383629	HOLDING CO	NE	N/A	C				No
(62) SUGAR LAND DOCTOR GROUP 1317 LAKE POINT PARKWAY SUGAR LAND,TX77478 45-4270163	MEDICAL CLINIC	TX	N/A	C				No
(63) TOWSON MANAGEMENT INC 7601 OSLER DR TOWSON,MD21204 52-1710750	MGMT SERVICES	MD	N/A	C				No
(64) TRINITY MANAGEMENT SERVICES ORGANIZATION 380 SUMMIT AVE STEUBENVILLE,OH43952 34-1471026	MGMT SERVICES	OH	N/A	C				No

Schedule R (Form 990) 2019

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

Yes

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ST JOSEPH'S SURGERY CENTER LP	S	799,829	SEE PART VII

Schedule R (Form 990) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation
PART V, LINE 2 COLUMN (C)	PART V, LINE 1S - AMOUNTS REPORTED UNDER TRANSACTION TYPE "S" REPRESENT FUNDING FROM PARTNERSHIPS VIA K-1 DISTRIBUTIONS.

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PORT CITY LLC IS COMMITTED TO FURTHERING THE HEALING MINISTRY OF JESUS THROUGH THE DELIVERY OF AFFORDABLE HEALTH CARE, ADVOCACY FOR THE POOR AND COMMUNITY PARTNERSHIPS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	7
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	202
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	292,601
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,963,029	16,460,764
9	Program service revenue (Part VIII, line 2g) .........	647,779,550	664,947,163
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	4,762,408	7,753,740
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,580,065	3,601,780
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	657,085,052	692,763,447
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	11,665,745	13,723,036
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	591,542,367	629,343,548
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	603,208,112	643,066,584
19	Revenue less expenses. Subtract line 18 from line 12.......	53,876,940	49,696,863
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	592,142,580	716,107,160
21	Total liabilities (Part X, line 26).............	172,415,126	242,245,665
22	Net assets or fund balances. Subtract line 21 from line 20.....	419,727,454	473,861,495

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 530,696,678 including grants of $ 13,723,036 ) (Revenue $ 629,329,151 )
	ST. JOSEPH'S MEDICAL CENTER (SJMC) OPERATES AND IS LICENSED AT THE SAME LEVEL WITH THE STATE OF CALIFORNIA, SERVING THE COUNTY OF SAN JOAQUIN AND OUTLYING AREAS. SJMC IS A 355-BED LICENSED ACUTE CARE FACILITY, PROVIDING GENERAL MEDICAL/ SURGICAL CARE, OBSTETRICS, NEONATAL ICU, EMERGENCY SERVICES, CANCER SERVICES, WITH SPECIALITIES IN CARDIAC SURGERY AND CARDIOVASCULAR CARE, RESPIRATORY, AND ORTHOPEDICS. THERE ARE NUMEROUS ANCILLARY AND OUTPATIENT SUPPORT SERVICES.

4b	(Code: ) (Expenses $ 25,815,038 including grants of $ ) (Revenue $ 24,062,015 )
	ST. JOSEPH'S BEHAVIORAL HEALTH CENTER (BHC) OPERATES AND IS LICENSED AT THE SAME LEVEL WITH THE STATE OF CALIFORNIA, SERVING THE COUNTY OF SAN JOAQUIN AND OUTLYING AREAS. BHC IS A 35 BED ACUTE PSYCHIATRIC AND CHEMICAL DEPENDENCY HOSPITAL, PROVIDING BOTH INPATIENT AND OUTPATIENT SERVICES.

4c	(Code: ) (Expenses $ 7,725,648 including grants of $ ) (Revenue $ 11,263,396 )
	ST. JOSEPH'S MEDICAL CENTER HOME HEALTH (SJHHA) OPERATES AND IS LICENSED AS A HOSPITAL BASED HOME HEALTH AGENCY WITH THE STATE OF CALIFORNIA. SJHHA PROVIDES SKILLED NURSING CARE SERVICES, SOCIAL SERVICES, OCCUPATIONAL, PHYSICAL, AND SPEECH THERAPIES, AS WELL AS HOME HEALTH AIDES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses564,237,364

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) JON VANBOENING...................................................................... BOARD MEMBER	2.00 ................. 50.00	X			0	1,545,360	220,563
(2) DONALD WILEY...................................................................... PRESIDENT AND CEO	50.00 ................. 0.00		X		0	1,212,772	139,147
(3) JOHN PETERSDORF...................................................................... VICE CHAIR	2.00 ................. 50.00	X	X		0	1,117,159	168,320
(4) RICHARD CARVOLTH MD...................................................................... BOARD MEMBER	2.00 ................. 50.00	X			0	694,664	93,688
(5) KEVIN WALTERS...................................................................... BOARD MEMBER	2.00 ................. 50.00	X			0	597,976	101,357
(6) KARL SILBERSTEIN...................................................................... FORMER OFFICER	0.00 ................. 0.00			X	0	452,107	51,273
(7) ANDREA NIKKI OCHOA...................................................................... CHIEF FINANCIAL OFFICER	50.00 ................. 0.00		X		0	269,623	46,503
(8) JEFF COLLINS...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(9) TOM HANENBURG...................................................................... BOARD MEMBER (THRU 2/27/20)	2.00 ................. 0.00	X			0	0	0
(10) DEBRA CUNNINGHAM...................................................................... CHAIR	2.00 ................. 0.00	X	X		0	0	0
(11) CORWIN HARPER...................................................................... SECRETARY	2.00 ................. 0.00	X	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	5,889,661	820,851

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,020,960
e	Government grants (contributions)		1e	13,103,524

f	All other contributions, gifts, grants, and similar amounts not included above		1f	336,280

g	Noncash contributions included in lines 1a - 1f:$		1g	111,057

h Total. Add lines 1a-1f.......		16,460,764

		Business Code
2a	PATIENT NET OF CHARITY AND PRICE	900099	433,401,625	433,401,625
b	MEDICARE / MEDICAID PAYMENTS	900099	229,474,773	229,474,773
c	MEDICAL OFFICE BUILDING	621300	642,244	642,244
d	PROGRAM RELATED RENTAL INCOME	900099	619,678	619,678
e	LABORATORY	621500	292,601		292,601
f	All other program service revenue.		516,242	516,242
g	Total. Add lines 2a–2f .....		664,947,163

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,332,754			2,332,754
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		142,351	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		142,351	6c
d	Net rental income or (loss).......			142,351			142,351
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		134,780,844	7a
b	Less: cost or other basis and sales expenses		129,359,858	7b
c	Gain or (loss)		5,420,986	7c
d	Net gain or (loss).........			5,420,986			5,420,986
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CHFT CREDIT		900099	1,460,136			1,460,136
b	CAFETERIA		722514	1,198,567			1,198,567
c	LIFE LINE REVENUE		900099	225,374			225,374
d	All other revenue ....			575,352			575,352
e	Total. Add lines 11a–11d ......			3,459,429
12	Total revenue. See instructions.....			692,763,447	664,654,562	292,601	11,355,520

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	13,684,194	13,684,194
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	38,842	38,842
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	651,992		651,992
c	Accounting ...........	117,210		117,210
d	Lobbying ...........	53,875		53,875
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	307,178		307,178
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	438,637,425	385,370,592	53,266,833
12	Advertising and promotion ....	1,236,699	47,394	1,189,305
13	Office expenses .......	11,060,781	9,428,250	1,632,531
14	Information technology ......	20,323,891	404,809	19,919,082
15	Royalties ..
16	Occupancy ...........	6,075,658	5,978,265	97,393
17	Travel ............	412,729	274,472	138,257
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	126,549	89,936	36,613
20	Interest ...........	3,830,355	3,830,355
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	31,371,098	31,371,098
23	Insurance ...	4,203,834	4,203,834
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	72,336,521	72,332,791	3,730
b	MEDI-CAL PROVIDER FEE	32,247,978	32,247,978	0
c	FOOD COST	2,792,418	2,620,055	172,363
d	UNRELATED BUSINESS INCO	43,000		43,000
e	All other expenses	3,514,357	2,314,499	1,199,858
25	Total functional expenses. Add lines 1 through 24e	643,066,584	564,237,364	78,829,220	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			13,775	1	13,524
2	Savings and temporary cash investments .........			33,320,531	2	149,133,184
3	Pledges and grants receivable, net ......			101,843	3	371,565
4	Accounts receivable, net .............			88,254,354	4	80,200,663
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			1,775,122	7	1,661,924
8	Inventories for sale or use ............			5,741,494	8	5,819,245
9	Prepaid expenses and deferred charges ......			80,717,708	9	84,105,814
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	272,685,417
b	Less: accumulated depreciation	10b	27,951,146	257,728,002	10c	244,734,271
11	Investments—publicly traded securities .			39,346,465	11	50,849,993
12	Investments—other securities. See Part IV, line 11 .....			54,982,389	12	66,526,969
13	Investments—program-related. See Part IV, line 11 ..			2,500,617	13	1,881,278
14	Intangible assets ...............			10,310,000	14	10,310,000
15	Other assets. See Part IV, line 11 ...........			17,350,280	15	20,498,730
16	Total assets. Add lines 1 through 15 (must equal line 33)...			592,142,580	16	716,107,160

17	Accounts payable and accrued expenses .....	74,929,302	17	147,928,633
18	Grants payable ...	0	18	0
19	Deferred revenue .........	2,585,660	19	2,536,881
20	Tax-exempt bond liabilities .........	0	20	70,205,539
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	4,236,510	23	4,248,456
24	Unsecured notes and loans payable to unrelated third parties ..		24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	90,663,654	25	17,326,156
26	Total liabilities. Add lines 17 through 25..	172,415,126	26	242,245,665

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	419,727,454	27	473,861,495
28	Net assets with donor restrictions ...........	0	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	419,727,454	32	473,861,495
33	Total liabilities and net assets/fund balances ........	592,142,580	33	716,107,160